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[Social conditions in the daily life of asthmatic patients].

To investigate the social conditions in the daily lives of asthmatic patients in Japan, a nationwide survey was performed using a questionnaire compiled by a joint research group and conducted by The national hospital treatment joint research group and The national sanatorium central research group. This study was carried out on 3,331 patients with childhood asthma and 4,398 patients with adulthood asthma in 1995. The results were as follows. (1) More than half of the asthmatic patients had been admitted to hospital at least once. (2) When experiencing an asthmatic attack, more than 80% of patients had difficulties with daily activities. Even when not experiencing an asthmatic attack, 14% of patients with childhood asthma and 40% of patients with adulthood asthma had difficulties with daily activities. The frequency of difficulties in daily life increased when the asthma was more severe or the patient was elderly. (3) More than 60% of adulthood patients felt that there were obstacles to their hopes or plans in life. The frequency of obstacles increased in patients with more severe asthma and in more elderly patients. (4) Fifteen percent of adult patients experienced work disabilities due to asthma (giving up work, changing job, leaving school, changing their school). (5) Because of asthmatic attacks, 64% of child patients and 49% of adult patients needed to take at least one day off. The outcome of this survey highlighted the condition of asthmatic patients in Japan. During the treatment of asthma, not only control of asthmatic attacks but also the social conditions of the patients in their daily lives should be considered and addressed.

Activities of Daily Living↗

Historical declines in tuberculosis in England and Wales: improving social conditions or natural selection?

OBJECTIVES: A reinvestigation of the relationship between the decline of tuberculosis and improvement in social conditions in England and Wales during Victorian times. DESIGN: A retrospective study using data published in the annual reports of the Registrar General from 1853 to 1910. MEASURES ASSESSED: The diseases studied, in addition to tuberculosis were dysentery and cholera, including their total and infant mortality. Social conditions were evaluated from earnings and population density per house. RESULTS: Tuberculosis mortality declined at an annual average rate of 1.71% (95% confidence interval [Cl] 0.77-2.63), whereas total mortality, infant mortality and mortality from cholera and dysentery and house population density showed no statistically significant decline over the same period. Real earnings increased by 1.05% (95% CI 0.29-1.81). CONCLUSION: Improving social conditions do not provide the total explanation for the decline in tuberculosis during Victorian times. Other factors, principally natural selection, probably played a role. Part of the current increase in tuberculosis may be caused by effective drug therapy eliminating natural selection.

Cause of Death↗

The importance of social condition in the hormonal and behavioral responses to an acute social stressor in the male Siberian dwarf hamster (Phodopus sungorus).

Social condition is an important factor in determining the behavioral and hormonal responses to a social stressor in the Siberian dwarf hamster (Phodopus sungorus). We predict that males housed with a female or a family (female and pups) will show an increase in the magnitude of the behavioral and hormonal responses to a male intruder compared to those of individually housed males. Three treatment groups were studied: individually housed males that had been previously group-housed in same-sex colonies (males, n = 10), males housed with a female (male + female, n = 9), and males housed with their female and pups (male + family, n = 12). Males were monitored for aggressive behavior toward an intruder male for 10 min. Blood samples were taken at baseline and after the encounter. Male + female and male + family groups spent more time in aggressive behavior (P < 0.05), such as attacking (P < 0.05) and fighting (P < 0.05), than did individually housed males. These same groups showed significant increases in plasma cortisol after the encounter (P < 0.01) whereas there were no significant increases in plasma cortisol in solitary males. All groups showed significantly lower levels of plasma testosterone (male, P < 0.001, male + female, P < 0.05; male + family, P < 0.01) whereas a significant increase in prolactin occurred only in the male + family group (P < 0.05). There was a significant positive correlation between postencounter cortisol levels and total number of minutes spent in aggressive behavior (P < 0.05). These results demonstrate that the introduction of a novel intruder male results in an activation of the hypothalamic-pituitary-adrenocortical axis and a suppression of the reproductive axis. Furthermore, pairing of a male with a female alters the behavioral and hormonal responses to an intruder male.

Aggression↗

Children with myelomeningocele: the impact of disability on family dynamics and social conditions. A Nordic study.

Family dynamics and social conditions were studied of 527 children with myelomeningocele aged four to 18 years from Denmark, Finland, Norway and Sweden; the control group was a representative sample of 7792 children of the same age-range and from the same countries. Information was obtained from postal questionnaires and from patients' charts. Overall, there were more similarities than differences between index and control families, the major difference occurring in measures related to the mothers' situation. Variations within groups of index families were in many respects more important than differences between index and control families. In spite of the different welfare systems developed to support families with disabled children, this study clearly showed that the responsibility for the care of the disabled child still lies primarily with the mother. Increased efforts must be made to meet the needs of these mothers.

Adolescent↗

Historical declines in tuberculosis in England and Wales: improving social conditions or natural selection?

UNLABELLED: A reinvestigation of the relationship between the decline of tuberculosis and improvement in social conditions in England and Wales during Victorian times. DESIGN: A retrospective study using data published in the annual reports of the Registrar General from 1853 to 1910. The diseases studied, in addition to tuberculosis were, dysentery and cholera including their total and infant mortality. Social conditions were evaluated from earnings and population density per house. Tuberculosis mortality declined at an annual average rate of 1.71% (95%CI 0.77 to 2.63) whereas total mortality, infant mortality and mortality from cholera and dysentery and house population density showed no statistically significant decline over the same period. Real earnings increased by 1.05% (C10.29 to 1.81). Improving social conditions do not provide the total explanation for the decline in tuberculosis during Victorian times. Other factors, principally natural selection, probably played a role. Part of the current increase in tuberculosis may be caused by effective drug therapy eliminating natural selection.

Biological Evolution↗

Short stature as an effect of economic and social conditions in childhood.

Only a few studies on the effect of environmental factors on height are based on adults and none, that we could find, relates adult height to both economic and psycho-social conditions in childhood. The aim of this study is to investigate whether four indicators of economic and psycho-social conditions during childhood are related to a variation in adult height and whether these factors can explain the variation in height between men and women from different childhood classes. The study is based on data derived from a study of living conditions in Sweden conducted in 1991. Beside childhood socio-economic group, indicated by father's occupation, we employ four indicators of economic and psycho-social conditions during the childhood period, previously employed elsewhere. These are economic hardship, large family, dissension in the family and disunited family during childhood. The prevalence of short stature differs significantly by three of the four indicators on economic and psycho-social childhood conditions. It is also more common if the person has grown up in a disunited family, but this effect is not significant. The proportion of short persons also varied significantly by childhood socio-economic group. On the whole, short stature in adulthood seems to be a reflection of a number of adverse conditions in childhood, both economic, status related and psycho-social, and can, consequently, be seen as summing up the whole childhood period rather than merely reflecting differences in nutrition or any other specific condition.

Adolescent↗

Levels of mortality, education, and social conditions in the 107 local education authority areas of England.

STUDY OBJECTIVE: To investigate the relationships between education, social conditions, and mortality. DESIGN: An ecological study relating several measures of mortality to local rates of educational attainment at age 15/16 years and scores on the Department of the Environment's index of local conditions. SETTING: England and its 107 local education authority areas in 1991. MAIN RESULTS: Educational attainment was closely associated with all cause, coronary, and infant mortality and strongly associated with the index of local conditions. This social index was also closely associated with all the measures of mortality. In multiple regression, the social index was the stronger correlate of all cause mortality but for coronary and infant mortality, educational attainment remained highly statistically significant. CONCLUSIONS: Area levels of both educational attainment and deprivation-affluence are strong correlates of local mortality rates in England. In these analyses educational attainment may be indexing the general cultural level of a community. Preliminary investigation with these ecological data suggests that deprivation-affluence has the stronger association but a surer assessment of their relative importance will require individual level information.

Adolescent↗

[Social conditions of suicidal poisonings].

The paper presents the results of a study of social conditioning of suicidal poisonings conducted in the years 1994-1996. The study was of the case-control study type and covered 542 intoxicated patients treated in the Toxicology Department of the Medical Faculty of the Jagiellonian University in Kraków. The studied population consisted of 323 patients poisoned in suicidal attempts (the studied group) and 219 accidentally poisoned (the control group). The objective of the study was to determine social conditioning of suicidal poisonings. It has been found that the risk of suicidal attempt was 2.3 times higher among divorced or separated people; 2.2 times higher among those, who had recently lost their jobs; 2.4 times higher among people having financial problems while nearly twice lower among individuals having more children.

Adult↗

Social conditions in a total population with long-term functional psychosis in three different areas of Stockholm County.

A number of social conditions regarding interpersonal relations, housing and employment were studied in a total population of individuals with long-term functional psychosis (n = 341) drawn from the population aged 18-64 years inhabiting three different areas of Stockholm County, altogether about 57,000 inhabitants. Individuals were included irrespective of whether they had a psychiatric treatment contact or not. They were mostly unmarried (57%) and living alone (64%). Most were unemployed (69%) and over half received a disability pension. However, 76% had their own flat and a reasonable financial standard, not deteriorating with illness duration. The diagnosis of schizophrenia led to poorer social conditions, as did early age at onset, male sex and co-morbidity of substance abuse. A larger number of individuals lived in an institution in the urban area while a greater number lived with relatives in the rural area.

Adolescent↗

Awareness of negative social conditions among mentally retarded, emotionally disturbed outpatients.

Many mentally retarded people experience negative social conditions for long periods in their lives. These include the stigmatizing effects of being labeled mentally retarded, rejection and ridicule, segregation, infantilization, social disruption, restricted opportunities, and victimization. Many mildly and some moderately retarded people are highly aware of these negative social realities and can articulate them in detail during psychotherapy interviews; the authors describe three such patients. There is a need for research on the possible effect of prolonged exposure to negative social conditions on the mental health of mentally retarded persons.

Adult↗

Street children in Pakistan: a situational analysis of social conditions and nutritional status.

This paper examines the social conditions and nutritional status of street children in Pakistan. Nutritional status is evaluated by an assessment of height and weight relative to age. A heterogeneous sample of 108 street children in the twin cities of Rawalpindi and Islamabad was studied. One hundred and one of them were children "on the street" having regular family contact; seven were "of the street", without any family contact. Most street children came from large families which had recently moved to the city in search of economic opportunities. Their parents had low education levels and were either unemployed or employed in unskilled occupations. Poverty clearly was an important factor. The majority of the children moved to the street to augment family income. Most of the children were males (81%) and the average age at beginning life on the street was under 10 years. The majority was working 8-12 h daily with an average income of Rs. 40-60 per day (USD 1 = Rs. 60). Important issues were parental exploitation, police harassment, abuse, and the impact of other street peers in their lives. The distribution of height-for-age relative to the National Center for Health Statistics (NCHS) reference standard showed that 20% were stunted and 12% had wasting. Wasting was equal between sexes, while fewer girls than boys were stunted. The study concludes that the issue of street children in Rawalpindi and Islamabad is mainly one of "children on the street," while "children of the street" are an exceptional phenomenon. It was noted that, with some exceptions, street children in other world regions share similar risk factors and backgrounds. Findings from this study will facilitate both the identification of high-risk families, i.e. those whose children are likely to take to the street, and timely preventive and rehabilitative measures.

Age Factors↗

Conditioned social aversion in the male Mongolian gerbil (Meriones unguiculatus).

Adult male Mongolian gerbils formed conditioned social aversions to young male conspecifics. The basic paradigm consisted of pairing a subject with a young animal (test stimulus) for 5 min and then injecting the subject with lithium chloride to produce gastrointestinal distress. When retested 48 hr later, the subject avoided the animal used as a test stimulus, as indicated by significantly decreased investigation time and approach frequency. Through a series of experiments on dose level, delay of toxin injection, and stimulus generalization, it was demonstrated that a dose of .03 ml/g body weight of .15 M LiCl is effective, the injection of the toxin should be given within 15 min of the preliminary social pairing, the social aversion formed is specific to the particular first paired stimulus animal, and isolation between test sessions is necessary for an aversion to develop. This paradigm of conditioned social aversion extends our knowledge of the learned aversion process and demonstrates that this type of learning can be generalized to a social situation by gerbils.

Animals↗

Wives' convergence with their husbands' alcohol use: social conditions as mediators.

OBJECTIVE: This study examines, in a general population, how the association of wives' alcohol use with their husbands' is mediated by social conditions such as working and child-rearing roles, age, marital happiness and socioeconomic levels. METHOD: Data come from the Québec Health and Social Survey 1992-93. The sample comprised 6,582 couples; 3,872 couples after weighting. Regression analyses assessed the contribution of husbands' drinking to wives' drinking, independently, as well as in interaction with social conditions. Frequency of drinking in general and frequency of five or more drinks per occasion (5+) were analyzed. RESULTS: Wives' drinking is positively related to their husbands' drinking, both in terms of frequency of drinking and, to a lesser degree, of frequency of 5+. The drinking frequency association is not modified by working or child-rearing roles, nor by age, but is more marked for couples of higher socioeconomic levels and for wives happy with marital life. The frequency of 5+ association is not modified by marital happiness or by wives' working roles, but is more marked for couples of higher socioeconomic levels, for couples with a child at home and for younger women. CONCLUSIONS: This study highlights the contribution of social factors to the association of wives' drinking with their husbands' and suggests that these social factors operate through structuring marital drinking interactions. Further research is needed to clarify the complex social processes that mediate the spousal drinking association.

Adolescent↗

Course and outcome of drug abuse and medical and social conditions in selected young drug abusers.

The course and outcome of drug abuse and medical and social conditions were investigated by following--in some aspects for up to 10 years--selected groups of young drug abusers who had had contact with health care and social welfare authorities in Gothenburg at the end of the 1960's. The follow-up was carried out by studying different registers and through interviews. The abusers were compared with a control group matched in terms of sex, age and daily sickness allowance. Abuse of cannabis predominated (2:1) over heavier drugs (primarily central stimulants i.v.) in the out-patient materials, while the reverse was the case in the in-patient material. About 40% of the drug users were interviewed and judged to be representative of their groups. After 4-6 years, 36-49% of the males and 23-48% of the females in the different materials were found registered as drug abusers; 22-38% of the men and 11-19% of the women were found after 8-10 years. According to the interviews, drug abuse persisted in 56-71% of the men and 26-60% of the women after 4-6 years and in 44-69% of the men and 13-36% of the women after 7-9 years. Abuse of cannabis persisted more often than abuse of heavier drugs, and had a lower mortality. Between 40 and 55% of drug abuse in the out-patient material, as well as among males in the social welfare material, was hidden during the follow-up period. The hidden abuse involved primarily cannabis; abuse of heavier drugs was generally known to the health care or social welfare authorities. Repeated or lengthy sick leave was more common than in the control group. In-patient adult psychiatric treatment was common among those in the health care material, although 40% of those in the social welfare material had also received such treatment. A diagnosis of drug abuse clearly predominated. Treatment of hepatitis was noted for 30-40%. More than 90% of drug abusers were registered with the social welfare authorities compared with less than half of the controls. Possession of driving licence was less common and the males had less often completed basic military training. The majority of those not registered for drug abuse after 4-6 years were employed or studying, and had considerably less need for social welfare and sick leave than those who were registered.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

The social condition of a cohort of peasant farmers in rural community in southwest Nigeria.

This study focused on the psychosocial condition of a cohort of rural farmers, highlighting the social condition of their children, their life style, life events in the past year, the extent of their involvement in farming, the sufficiency of material sustenance from their products, their unmet needs and social aspirations, difficulties encountered in farm work, satisfaction with farming, and psychological distress. In 1992, 186 farmers were interviewed during health education visits at farm villages in Idere town, Oyo State. There were 161 (87%) males and 25 (13%) females mean age 49.9 (sd 11.7) years: who were illiterate, mainly polygamous, with 4-6 children per household. Only two families had a child each in institutions of higher learning. The general picture that emerged was that of a peasant, hardworking (six-day per week) farmer who relaxes with a game of cards in the evenings. His greatest problem is that of transportation and hiring extra hands for work. He is impressed by the yield from his farm. Compared with urban junior civil servants, the farmers had significantly lesser life events and GHQ-12 (psychological symptoms) scores. They had unmet social needs and were not satisfied with their condition of living. Meeting some of the basic needs of these farmers will boost their morale, enhance yield, and lower prices of food for the general population.

Adult↗

Drug-related medical and social conditions in military conscripts.

Drug-related medical and social conditions were investigated in a sample of military conscripts from Gothenburg. The men participated in a questionnaire study concerning drug abuse in 1969/70 and were traced in different registers for 5 to 7 years. Abusers demonstrated an over-consumption of psychiatric and social care. Of all military conscripts, 4% had received in-patient psychiatric care. A total of 18% of those who were high-frequency drug users received the same care. The predominant diagnosis at the time of psychiatric treatment was drug abuse. 42% of all military conscripts were registered with the Social Welfare Administration, while the figure was 71% for high-frequency drug users. The proportion of those with repeated or lengthy sick leave was greatest among those who indicated use of drugs in the questionnaire. The proportion who had driving licenses was lower among drug users and 39% of the high-frequency drug users were granted exemption from military service during the inspection proceedings compared with less than 10% among the remaining groups. Cumulative frequencies of registrations showed that a number of curves were high for groups of drug users at an early stage and that the curves had not leveled off at the end of the follow-up period.

Adolescent↗

Harsh social conditions and perinatal survival: an age-period-cohort analysis of the World War II occupation of Norway.

OBJECTIVES: The hypothesis was tested that unfavorable social conditions are associated with poor perinatal survival through direct effects on pregnancy or, more indirectly, through effects on mothers born under such conditions. The occupation of Norway by Nazi Germany was used as a period of social hardship. METHODS: Data from Norwegian vital statistics and the Medical Birth Registry were used to describe perinatal mortality during World War II and also a generation later, among babies born to mothers who had themselves been born during the war. Logistic regression was used to identify a possible cohort effect among mothers born in 1940 through 1944 compared with mothers born before or after that period. RESULTS: Harsh conditions in Norway during the occupation increased childhood mortality. However, perinatal mortality declined during that period. Likewise, no adverse effect was seen on the survival of babies born to mothers who had themselves been born during the war (odds ratio = 1.00; 95% confidence interval = 0.96, 1.04). CONCLUSIONS: We find no evidence that wartime conditions in Norway impaired perinatal survival, either directly or through an effect on women born during the war. These data underscore how little is known about the ways that social conditions influence perinatal mortality.

Adolescent↗