Occupational mobility of primary male migrants to urban areas in Egypt.
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This case report contains the history of a man's exposure to benzene, trichloroethylene, and toluene. J suffered acutely from classic symptoms of toxic exposure to these compounds, such as fatigue, clumsiness, staggering, and hematopoietic depression. During his medical hospitalization, he was exposed to further organic insults, such as being treated with medications like Cytoxan and medications to treat an abscess in his right parietal lobe. After the acute exposure and after the abscess had resolved, his functioning on neuropsychological testing was still depressed, as he had a Full Scale IQ of 105, whereas at the time of the forensic evaluation he had a Full Scale IQ of 114. It would therefore appear that he did have some mild deficits when originally discharged from the hospital. While he reported having continual mental status changes at the time of the offense and even at the time of the forensic evaluation, it was not felt that these played a significant role in the commission of the offense. Comprehensive forensic evaluation suggested that psychological reactions to his illness and an underlying personality disorder were more direct contributors to the criminal acts. J was therefore recommended and ultimately found to be responsible for his behavior, according to the law.
Increased nonspecific bronchial responsiveness (NSBR) may be a risk factor for the development of chronic airflow obstruction. We evaluated this hypothesis in a cohort of 378 underground coal miners and working nonminers. Methacholine testing was performed at the beginning and end of a 5-yr study period. Spirometry was repeated at 6-mo intervals and individual 5-yr FEV1 slopes were calculated by linear regression. Relationships between FEV1 slopes and NSBR were examined using multiple linear regression models, controlling for FEV1 level, smoking, and mining. Increasing NSBR at the initial survey was associated with a somewhat greater rate of subsequent FEV1 decline. Methacholine responders at the final survey had a considerably increased rate of decline during the previous years. Responsiveness status changed over the 5 yr in 22% of the subjects. Both the development and persistence of increased NSBR were strongly associated with higher rates of FEV1 decline. In contrast, FEV1 declines were not accelerated among workers with increased NSBR that reverted to normal. Smoking and mining were both independently associated with FEV1 declines, but did not substantially modify the effect of NSBR. Due to its variability over time, NSBR testing predicts lung function decline only in some individuals, and its value as a prognostic test for chronic airway disorders is limited. Because improvement in bronchial hyperresponsiveness was associated with a reduction in the rate of FEV1 loss, interventions directed at preventing or reducing nonspecific airway hyperresponsiveness should be investigated.
The hypothesis that one must include life-style changes in order to accurately capture the true relationship between medical expenditures and health status is explored, using data from 22 countries over a 20-year period. A simultaneous model is estimated using a variety of indicators for life style as well as health status. Changes in life style, aging of the population and changes in occupational risk are modeled as influences on medical expenditures: medical expenditures and changes in life style are modeled as having direct influences on health status. The results are consistent with the existence of a positive link between medical expenditures and health status.
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Many have studied the effects of different lifestyles on disease, mortality or risk factors for a disease, but little is known about how behaviour is changed in the population. We studied the need for counselling and its effect on willingness and ability to change lifestyle, and subsequent changes in CHD risk factors. All 152 male employees in a computer company, 25-45 years of age, were invited to participate. Subjects were randomized into an intervention group (I-group) and a control group. The I-group was divided into subgroups based on baseline behaviour and risk factor status. Changes were evaluated after 1 year. After an initial health examination, participants from the I-group were counselled at baseline and after 5 months. Eighty-five (56%) males participated. Twenty-nine were assigned to a control group and 56 to an intervention group (I-group) (dropout = 8). An exercise group (E-group) was advised to exercise aerobically three times/week, a diet group to reduce the intake of saturated fat and increase fish products, and smokers to quit smoking. Forty subjects were recommended one or more behavioural changes and eight had no need. Thirty-four were willing to make behavioural changes. Compared to the control group, the fitness level increased (P < 0.01) and body weight decreased in the I-group (P < 0.05). It may be concluded that individual counselling promotes regular exercise with subsequent improvements in CHD risk factors. The diet- and smoking counselling models were less successful in terms of adherence.
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OBJECTIVES: To compare 3 cognitive tests, used on admission, for predicting discharge functional outcome and to assess the efficacy of these tests in predicting functional outcome at discharge in stroke patients undergoing rehabilitation. DESIGN: Cohort study. SETTING: Geriatric rehabilitation department of a tertiary care hospital in Israel. PATIENTS: Sixty-six patients undergoing acute inpatient comprehensive rehabilitation after first clinical stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUREMENTS: Cognitive status was assessed with the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), the Mini-Mental State Examination (MMSE), and the cognitive subscale of the FIM instrument. The FIM motor subscale was used to assess functional outcome status. Functional gain was determined by the motor FIM gain (efficacy), and the relative (to potential) functional gain was determined by the Montebello Rehabilitation Factor Score. Efficiency was calculated by efficacy divided by the length of hospital stay. RESULTS: A significant increase in total FIM scores (34.8 points) occurred during rehabilitation mainly because of improvement in motor functioning (31.5 points). Significant improvement in global cognitive status was documented by all 3 tests. Intertest correlation coefficients ranged between.47 and.67. The LOTCA showed somewhat higher correlation coefficients with most of the parameters of functional motor outcomes. Correlation between the MMSE and FIM cognitive subscale and these outcome parameters were nearly identical. CONCLUSION: The LOTCA is slightly better than the MMSE and the FIM cognitive subscale in predicting functional status change after stroke rehabilitation but it is a time-consuming and exhausting instrument to use. The FIM cognitive subscale requires a better overall understanding of the patient's situation at time of administration and therefore is less convenient for the initial assessment. The similar correlation of all 3 tests with functional outcomes and the simplicity of administration of the MMSE suggests its use in the initial assessment of stroke patients.
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PURPOSE: To examine health risk changes among participants of a multicomponent worksite health promotion program. DESIGN: A study using health risk changes among health risk appraisal (HRA) participants linked to program participation records. Baseline risk and participation in multiple programs were examined in relation to risk change in multivariate models. SETTING: Worksite health promotion programming sponsored by the United Auto Workers (UAW) and General Motors (GM). SUBJECTS: Active employees (12,984) who voluntarily participated in an HRA in each of two program years. INTERVENTION: The nationwide program was a mailed HRA and a 1-800 nurse line. A pilot program (implemented in two cities) added screening, wellness programs, a materials resource, and, for high risk participants, health coaching and vouchers for medical office visits. MEASURES: Using 13 selected health risk factors from the HRA, changes in overall health risks were measured as program outcomes in three ways: one-directional, net, and risk status change. RESULTS: A greater decrease in the number of health risks was observed with increased program participation. The decrease was significantly related to the number of baseline risk factors and eligibility for high risk programs. Associated with program participation, the number of people at low risk status increased from 70.1% to 71.3% at year 2 among nationwide participants and from 52.4% to 58.9% among pilot participants. CONCLUSIONS: Participation was associated with a significant impact on health risk. Baseline risk of participants and eligibility for high risk programs were necessary factors to control when measuring program effects on health risk changes.
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"This study describes...changes in marital status during [the twentieth] century, by analyzing each census result conducted during the time of Japanese occupation and after the war in Taiwan. Taking the age specific statistics, which include sex ratio, proportion...ever married, the widowed, and the divorced, as well as rates of divorce and remarriage, this study presents the marriage patterns in terms of formation, dissolution and reformation in Taiwan of this century." (SUMMARY IN ENG)
The theoretical basis of a methodology that is designed for investigating population movements and can be used for economic planning purposes is outlined using Markovian models. "The object of analysis in these models is population change, which manifests itself in three main forms: natural changes, physical movement (migration), and mobility of a social or production type (shifts between branches or skill groups). These methods classify each person according to particular characteristics, which enable [the author] to break down the population into homogeneous nonintersecting groups."
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This article examines Mexican migration into South Texas in recent decades and focuses on changes in the characteristics of the migrants' households. An ethnographic approach is used in examining 56 permanent, immigrant households. "This article introduces a hypothesis for explaining the increase and permanency of household immigration." It is found that "immigration often leads to downward social mobility with respect to legal status of household members, type of employment, and property ownership. Of particular note is the transformation of the household from a single to a multiple worker unit, in response to agricultural labor demands and growing employment opportunities in the non-agricultural sector."
"At the beginning of the seventies, important economic investments aimed at developing and commercializing the newly discovered oilwells were made in the state of Tabasco [Mexico]. As a result of this, the distribution and the social growth of the population in this state changed. This paper analyses the general characteristics of these changes, particularly those related to migration.... Generally speaking, the most important migratory movements which took place in this state during the oil boom were from one municipality to another and not from other states to Tabasco, as was thought at first.... This paper also describes the direction of the migratory flows and provides information about the sex of the migrants and about their insertion within the sphere of employment." (SUMMARY IN ENG)
Differential fertility in Italy by occupation is analyzed using census data. The author uses the own-children method to develop retrospective estimates of period fertility for women in 1976 and 1981. The occupational status categories used are "employed in the same sector, employed in a different sector, no longer employed, new employed, never employed. A strong relation appears between work status changes and fertility trends: the women who recently obtained a new job touch the lowest level of fertility, while those who left their job reach the highest level." The impact of migration and nuptiality is also considered. (SUMMARY IN ENG AND FRE)
"In recent years, poverty has become a serious issue in the socioeconomic development of China. One of the most important features of poverty is 'poor population quality', a factor that also causes poverty. Human resources development (HRD) strategies have been used as a weapon against poverty in many developing countries; some have proven to be quite effective. This article, which researches the relationship between HRD indicators and poverty status, finds that enhancement of education levels, improvement of health status, the gaining of skills and experience, increasing time away from home and choosing suitable occupations, all can contribute greatly to the reduction and alleviation of poverty."