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PubMed1999

Suicide mortality in Finland during an economic cycle, 1985-1995.

This is a study on associations between suicide mortality, unemployment, divorce rate and mean alcohol consumption during an economic cycle in Finland, from 1985 to 1995. Data on annual suicide mortality, gross domestic product, unemployment, divorce rate and mean alcohol consumption were collected from official Finnish statistics. Regression analyses using a correction for serial autocorrelation were performed. Suicide mortality in both males and females increased during an economic upswing from 1985 to 1990 and decreased during an economic recession from 1990 to 1995. Suicide mortality was not associated with unemployment or divorce rate. These results are opposed to those of many previous studies. However, a significant association was found between male suicide mortality and mean alcohol consumption, in accord with other studies. In conclusion, the results suggest diversity in associations between suicide mortality, socioeconomic factors and alcohol consumption.

Alcohol Drinking↗
PubMed2000

[Ecology and social organization of African tropical forest primates: aid in understanding retrovirus transmission].

The risk of transmission of primate viruses to humans is great because of their genetic proximity. It is now clear that the HIV group of retroviruses came from primates and that the origin of HIV1 is the chimpanzee subspecies of Central Africa, Pan troglodytes troglodytes. Many African primates are natural hosts of retroviruses and details of the natural history of both hosts and viruses are essential to understand the evolution of the latter. Data on the demography, ecology and behaviour of three species of primates (gorillas, chimpanzees and mandrills), studied in the Lopé Reserve in Central Gabon since 1983, are analysed to identify the factors that allow, or favour, disease transmission within each species, between different species and between primates and humans. The comparison of the relative degree of risk suggests that of the three species, chimpanzees are the most susceptible to exposure to infection both from conspecifics and from other species. With respect to humans, the comparative analysis suggests greater exposure to viruses of mandrills and gorillas than to those of chimpanzees. For primates, major risk factors are: large social groups; bites inflicted in fights; social grooming; and predation on mammals. However, given that contacts between social groups of the same species are rare, the spread of a virus through a population will be slow and uncertain. Hunting wild animals is the behaviour most likely to provide transmission routes for primate viruses into human populations because of the high probability of blood-blood contact. Not only the hunters themselves, but also women who prepare bush meat for cooking and people involved in trade of carcasses are at high risk of transmission of pathogens. Hunting of bush meat is increasing in Central Africa due to the economic recession and the spread of logging into the forests of the interior of the region. To counter the significant risk of transmission of known, as well as new, diseases from primates to humans, urgent measures are needed to attack the root causes of commercial hunting which is not only risk to public health but also a serious threat to biodiversity in the region.

Animals↗
PubMed2001

Male suicide mortality in eastern Finland--urban-rural changes during a 10-year period between 1988 and 1997.

AIMS: To investigate urban-rural differences in male suicide mortality between 1988 and 1997 in the province of Kuopio in eastern Finland. METHODS: Male suicide mortality between 1988 and 1997 was studied in eastern Finland. The data were collected from official autopsy reports. Age, marital status, household type, place of death, method of suicide and the region within the county were analysed. RESULTS: The age-adjusted male suicide mortality remained quite constant at 67 and 65/100,000 (> 15 years of age) in 1988 and 1997, respectively. In urban areas, a decline in suicide rates was noted in all age groups of men, whereas in rural areas, after an initial decline, a marked increase took place during the last years of the study period, especially among middle-aged and elderly men. This coincided with the time of recovery from an economic recession in Finland that particularly affected rural areas. CONCLUSION: Male suicide mortality may be regionally diverging in Finland.

Adolescent↗
PubMed1975

The Model Postmortem Examinations Act in the State of Connecticut, 1969-1974.

Five years following the 1969 passage of legislation patterned after the Model Postmortem Examinations Act, Connecticut has a central laboratory with administrative, autopsy, and toxicology facilities; 24-hour statewide reporting deaths; a records and data-processing system; and affiliation with a university health center. The state's population density, number and size of municipalities and police departments, absence of county government, and judicial appointment of coroner's were unique geographic-political features confronting implementation of the legislation. To effect a transition from the preexisting system, and because of the number of deaths reported and physicians involved, a dual system was developed for examinations and certification of deaths which differentiated autopsies performed at the central laboratory from those at community hospitals. Dissemination of procedures and forms for medicolegal autopsies conducted at community hospitals is planned in the near future. Although educational programs for graduates and law enforcement personnel have been initiated, there still exists a need for more active undergraduate and postgraduate training and a program of research and statistical reporting. Implementation of the statutes during a five-year period in which supplemental legislation and regulations were passed, changes that occurred in state administration, and budgetary restrictions mandated by economic recession has, however, resulted in the nucleus of a modern state medicolegal investigative system--a separately budgeted medical examiner's office, supervised by an independent administrative commission and located on the grounds of the University of Connecticut Health Center in Farmington.

Administrative Personnel↗
PubMed2002

[A blind bicycle repair man at the Stedelijk Museum: the exhibition and congress 'labour for the disabled' of 1928].

In the 1920's concern about the rising number of disabled unemployed urban poor led to the founding of the AVO (Dutch organization for labour care for the disabled) in 1927. The AVO presented the problem of the vulnerability of the physically and mentally disabled in the labour market as a matter of collective responsibility. At the Amsterdam AVO congress of 1928 expert contributors discussed the economic, social and medical aspects of disability and work. Simultaneously, a museum exhibition aimed at arousing the interest of the general public and at promoting a more understanding attitude towards the disabled. Though the twofold AVO manifestation raised an immediate favourable general response and the subject was put on the political agenda, the subsequent economic recession and war forestalled concrete measures. Essentially it was the first public debate on disability in the Netherlands.

Blindness↗
PubMedDate not supplied

Tuberculosis control: current status, challenges and barriers ahead in 22 high endemic countries.

BACKGROUND: Despite the fact that Directly Observed Treatment Strategy (DOTS) short course is cost effective and universally recommended by WHO for effective TB control, it is beyond the financial reach of several highly endemic countries. This article aims at identifying barriers in DOTS's implementation and progress in 22 high burden countries (HBCs) from TB. METHODS: Medline abstracts, published papers and WHO reports were retrieved, critically examined and compared keeping standard parameters of TB control in view. RESULTS & CONCLUSION: The increasing caseload, morbidity and mortality due to TB in high burden countries have become a major health challenge and threat to the health systems. The escalated burden of disease and deaths due to TB has posed a great threat to the international security. In the last decade little progress has been witnessed in the implementation of WHO's recommended strategy called DOTS in the 22 high burden countries. Afghanistan, Pakistan, India, Brazil, Zimbabwe, S. Africa and Uganda are some of the countries still facing challenges in the effective introduction, implementation and expansion of DOTS. Financial inabilities contribute greatly to the failure of respective national TB control programs. High burden countries are usually in the economic recession or passing through severe socio-political turmoil that has further reduced spending on TB control. Majority depends on the international assistance and put little domestic efforts. Coupled with the lack of political commitment to the issue of TB control, authors urge high TB control Program managers in HBCs to increase spending and pay a great deal of commitment to the universal implementation of DOTS, increase case detection and case management to attain their global targets.

Developing Countries↗
PubMed1992

Mortality trends of pancreatic cancer: an affluent type of cancer in Taiwan.

Interest in the increasing trends in pancreatic cancer mortality in Taiwan has recently emerged. The mortality data for pancreatic cancer in Taiwan from 1971 to 1988 for both sexes are presented to cast some light on the etiology of this ominous and yet little-known disease. A steeply increasing trend was found between 1975 and 1984 for both sexes; it dropped in 1985-86 and climbed again in 1987-88. The urban excess risks persisted in our study period of 18 years. Further study is mandatory to elucidate the etiological implications of dietary and other lifestyle changes on the magnitude of these rising secular trends and urban-rural gradients, particularly in the elderly, as well as the puzzling finding of cross-sectional drops in mortalities between 1985 and 1986. It is speculated that the drop may be associated with an economic recession that occurred in Taiwan between 1980 and 1981.

Adult↗
PubMed1991

[The expertise situation as pathoplastic factor].

Underlying attitudes of apprehension or desire have an essential pathoplastic function, especially in the situation of medical assessment. The functionality of symptoms and complaints requires a diagnostic approach which is not oriented simply towards the "exclusion of organic causes". Interaction between somatogenic and psychogenic factors is by far more common than sheer functionality. Although widely neglected in our medical teaching and literature, these problems are not confined to the mere assessment of temporary or permanent invalidity, but are of great importance for the entire medical sphere, including manifestations and course of a disease, therapeutic success etc. In Austria, the population of foreign workers is in a special position due to socio-economic preconditions, partly due to short-sighted policy devoid of psycho-hygienic considerations. This situation requires thorough analysis free of emotions, which should lead to the development of sensible, although in some respects belated, measures. The latest economical recession has revealed several faulty courses of development in our system of social and health insurance, which needs revision urgently lest it should collapse. In this respect, the medical profession is called upon to contribute to a necessary curtailment of excessive misuse within a system that has become inflexible during the past decades, thereby endangering the valuable achievements of social medicine.

Adult↗
PubMed1989

Ageing, status politics and sociological theory.

As a feature of social change and as an aspect of social stratification, ageing and age groups have been seriously neglected by sociological theory. This article attempts to conceptualize age groups in a multi-dimensional model of stratification which considers ageing in relation to economic class, political entitlement, or citizenship, and cultural life-styles. This multi-dimensional model provides an analytical basis for rejecting functionalist theories of ageing, which emphasize the positive functions of social disengagement, activity theories, which show that self-esteem in ageing is an effect of continuing social involvement, and Marxist social gerontology, which argues that retirement is determined by labour-market requirements in capitalism. The article concludes by developing a reciprocity-maturation curve of ageing which explains age stigmatization through exchange theory as an effect of declining social reciprocity. Both young and elderly social groups in a period of economic recession are perceived to be socially dependent, and become the targets of 'the politics of resentment'. The processes of social ageing can be located in the core of sociological theory, because they are connected fundamentally to the conditions of social solidarity.

Aging↗
PubMedDate not supplied

Repetitive strain injuries.

The semimechanized and repetitive nature of industry, the greater use of keyboards, and the need to boost production during an economic recession have led to a huge increase in repetitive strain injuries. The types of injury, their diagnosis and their treatment are discussed.

Activities of Daily Living↗
PubMed1982

[Comments on "Building blocks for a policy for the elderly"].

In the beginning of 1982 at last the third report of the government on the policy on the elderly was published. The two reports before were published in 1970 and 1975. The central issue is that the services available for the elderly should be maintained at the present level, despite the growth of the number of the aged and the economic recession. The policy as practiced in the last years is judged to be continued. However, a critical analysis of this policy is absent in the report. Neither does the report make choices; it describes the possible developments in the next decade. The facts and research -data used to describe these future developments are not critically considered. Still a lot of positive aspects may be mentioned; for example the fact that the policy on the policy starts before 65. Actually most figures deal with persons 55 and over. Also the attention given to scientific research is positively judged.

Health Policy↗
PubMed1995

[Excess mortality of severely handicapped patients in mandatory health insurance].

The introduction of compulsory long term care insurance as of 1.1. 1995 has temporarily brought to an end a whole range of controversial discussions, which have been strongly coloured by party political interests. The originally planned expenditure figure of at least DM 30 billion represents an enormous outlay in these time of economic recession. It is already abundantly clear that the premium payments will not be sufficient in the long run, nor will it be possible to increase these premiums arbitrarily. This therefore elicits the question as to whether it is possible to calculate in advance the cost of treatment for those "in serious need of nursing care" on the basis of various factors such as age, sex, underlying illness, therapy and social integration. Up to now, there has been very little statistical analysis of these parameters. For this reason, the company MDK has carried out a preliminary survey (which so far has only looked at a limited number of cases) in order to obtain a general idea of the variations in the period required for long term care. This survey has shown that there are two main groups of cases requiring care, which can be differently assessed on the basis of age and sex. On the one hand, there are those in serious need of nursing care, who, due to a life-threatening disease or as a result of an acute deterioration of an existing chronic condition (e.g. severe KHK, cirrhosis of the liver, decompensated renal insufficiency) die a relatively short time after the application for care is made.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[One-year experience as a clinical anaesthetist in England].

Current practice of British clinical anaesthesia is introduced, including anaesthesia in the operating theatre as well as obstetric analgesia in the labour ward. Although many people feel that British National Health Service has been affected by their chronic economic recession, the author's general impression is that the standard of anaesthetic care is kept at a quite high level despite financial difficulties. It is still valuable to experience clinical anaesthesia in the United Kingdom and the author encourages young Japanese anaesthetists to get an opportunity to work in British hospitals.

Anesthesia, Obstetrical↗
PubMedDate not supplied

Interrelation between Western type cancers and non-Western type cancers as regards their risk variations in time and space. VI. Chronological transition of various cancer risks of the world from 1975 to 1985.

We comparatively investigated the age-adjusted incidence rates (AAIRs) of overall cancers of the world between 1975 and 1985 to see whether or not any consistent change is in progress in the risk for cancer in general on a world scale. Results obtained are summarized as follows: 1) the total male population of the world, but not the total female population, experienced a significant rise in AAIR for cancers of all sites during the above 10 years. 2) In the comparison study of geographical subgroups, the above integral cancer risk significantly increased with time in the male population of Canada, USA-White, USA-Black, European continent (EC)-West, EC-others and Great Britain, and also in the female populations of both USA-Black and Great Britain. In other geographical subgroups the cancer risks for 1985 were also higher than those for 1975, but the differences were not statistically significant. 3) The above increase of cancer risk in general was accounted for by a surplus in weight of the increasing contribution of Western-type cancers over the decreasing contribution of non-Western type cancers to the integral cancer risk of a population. 4) Japan was found to be an exceptional case in that the risk for liver cancer (a non-Western type cancer) increased 3 to 8 fold from 1975 to 1985 in both male and female populations of Japan. Evidence was presented to suggest that the above increase of liver cancer incidence could be related to the persistence of social tension following the first oil crisis in 1973. In summary, the chronological transition patterns of cancer risk in Japan as well as in other parts of the world support our interpretation that social tension linked to the economic recession plays a crucial role in the production of recent changes of cancer risk in the world.

Age Factors↗
PubMed1995

Current challenges to the principles of medical law and their new interpretation.

The traditional function of the principles of medical law has been to protect the person of the patient against the use of power in health care. These principles have not generally been seen as factors which would also protect the patient economically. An analysis of the significance of the use of power in health care and a review of the field of damage sustained through erroneous procedures in the care relationship, make it possible to observe that the patient's need for legal protection is particularly great not only as regards factors related to the person, but also as regards the finances of the patient. On the other hand, evaluation of the relevant contents of the principles shows beyond doubt that they are to be conceived of generally as norms safeguarding the patient's rights. In Western countries in particular, where some years ago an economic recession set in, serious note should be taken of the wider interpretation of the principles of medical law as one potential means of furthering the well-being of the patient. In the application of legal rules affecting the legal position of the patient the principles of medical law may--like legal principles in general--be utilized both to guide the choice of a solution norm and to complement/ specify the solution norm. In both these roles the principles yield criteria for application of the law which lead to the taking into consideration of aspects relating to the patient's financial interests and assessments.

Decision Making↗
PubMed1998

[Quality assurance in a psychiatric day clinic. A catamnestic study with goal attainment scaling].

PURPOSE: For the second time after 1990, a community mental health service questioned the outcome quality of its day hospital in rehabilitating primarily psychotic patients. METHODS: In addition to the assessment of 66 persons at the beginning and at the end of an average of six months' treatment in the years 1990-95, a psychologist who had not been involved in the treatment interviewed 49 persons one year after discharge with the use of goal attainment scaling in five relevant fields. RESULTS: Due to the economic recession the goal attainment decreased with regard to the job situation in the sense that it was difficult to find unsheltered jobs. By defining the goals in accordance with the needs of the patients, an improvement in the lodging situation was observed. As a result of the first study, quality monitoring led to an improvement of the structures that promote spare time interests. Social contacts and coping with everyday life showed sustainable achievements. CONCLUSIONS: These achievements can be interpreted as a result of the comparably long time of exposure to social learning within the therapeutic milieu of the day hospital. This hypothesis of a positive correlation between the sustainability of the outcome and the length of treatment must be validated by another study.

Adult↗