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PubMed2001

Childhood neglect and cognitive development in extremely low birth weight infants: a prospective study.

OBJECTIVE: To examine the relationship between child maltreatment and cognitive development in extremely low birth weight infants, adjusting for perinatal and parental risk factors. METHODS: A total of 352 infants with birth weight of <1000 g were followed prospectively for 4 years. The data were analyzed with regard to perinatal and parental risk factors and referrals for suspected child maltreatment to government agencies. Perinatal risk factors included birth weight, gestation, gender, periventricular hemorrhage, ventricular dilation, home oxygen requirement, and necrotizing enterocolitis. Parental risk factors included maternal age, race, marital status, education, and hospital insurance status. Cognitive z scores were calculated at 1, 2, and 4 years, and head circumference z scores were calculated at birth, 2 years, and 4 years. RESULTS: Fifteen percent of infants were referred to child protective services for suspected child maltreatment. The adjusted general cognitive index at 4 years was significantly reduced in infants who were referred for neglect (-17.6; 95% confidence interval: -3.3, -31.9). Infants whose neglect was substantiated had a progressive decline in their cognitive function over time (cognitive z scores: -0.97, -1.37, and -2.05 standard deviations at 1, 2, and 4 years, respectively), compared with non-neglected infants (z scores: -0.04 to -0.36). They had a significantly smaller head circumference at 2 and 4 years but not at birth (adjusted z score at 4 years: -0.812; 95% confidence interval: -0.167, -1.458). Perinatal risk factors and physical disability were not related to maltreatment referral; only parental factors were independent predictors. CONCLUSIONS: Childhood neglect is associated significantly with delayed cognitive development and head growth. Addressing risk factors antenatally and in early childhood may improve outcomes.

Child Abuse↗
PubMed2003

[Reported morbidity and use of health services by working women, Brazil].

OBJECTIVE: Inclusion in the work force has become part of women's daily lives, and they have to cope with multiple tasks and manage double working shifts. A study was carried out to assess working women's morbidity and their use of health services. METHODS: By means of a household survey, chronic and acute morbidity (i.e. within 30 days of data collection) was reported by 1,157 women aged 10 to 49 years living in the southern area of the city of São Paulo, Brazil. Data were collected from January 1992 to January 1993. The relationship between employment and marital status, educational level and socioeconomic status was evaluated. RESULTS: Women who had a paid job were more likely to complain of acute or chronic morbidity. Also, these women tended to be less likely to seek medical services for their health problem. The most prevalent acute illnesses were: respiratory illnesses, especially influenza or colds (72/1,000), abdominal and pelvic pain (13.2/1,000), headaches (11.4/1,000), and hypertension (9.5/1,000). Regarding chronic complaints, hypertension (39.7/1,000), back pain (26.5/1,000), gastritis or inflammation of duodenum (24.6/1,000), and bronchitis (24.6/1,000) were the most prevalent conditions. CONCLUSIONS: Although employed women reported more health complaints than women who were not employed, their use of health services was equal to or less than that of women who were not employed for most health conditions studied.

Acute Disease↗
PubMed2001

Lung cancer, myocardial infarction, and the Grossarth-Maticek personality types: a case-control study in Fukuoka, Japan.

Grossarth-Maticek and colleagues have shown, in their prospective studies, a strong relationship of their personality types, Types 1 and 2, to cancer and coronary heart disease (CHD), respectively. Relevant information is limited from replication studies, and little is known about psychosocial factors in relation to cancer or CHD in Japan. Subjects included 95 cases of lung cancer (LC), 94 cases of myocardial infarction (MI) and 596 controls. The controls were men and women who visited a clinic for a health checkup. The Grossarth-Maticek personality types, Types 1 to 6, were assessed using the Short Interpersonal Reactions Inventory. The distributions of the 6 personality types were compared between the case and control groups, adjusting for sex and age class. The relation of each of the 6 types to LC and MI were examined in terms of odds ratio, using a logistic regression model controlling for age, sex, job status, education level, and smoking status. As regards the distribution analysis, Types 1 and 2 in the LC and MI groups each were not more prevalent than the controls, respectively. High score of the Type 1 scale was associated with a statistically nonsignificant decrease in LC risk. MI risk was significantly, positively associated with the Type 2 and 5 scales, and unexpectedly, positively related to the Type 3 scale. The present findings partly supported the Grossarth-Maticek theory, but there remain some conflicting issues to be confirmed in future studies.

Adult↗
PubMed1992

Current status of education and training in occupational health and their development programs in China.

There are 40 post graduate schools of public health in China, from where 1,400 students are graduating every year. Fourteen percent of them are going into occupational health field. A total of about 25,000 specialists are now working in the occupational health field. However, this number is only 1 percent of all health workers in China. Facts on the educational resources in China including responsible institutions and programs for such occupational health specialists are introduced and discussed. Finally a program for increasing the number of occupational health specialists in the Eighth Five-year Plan of China is introduced.

China↗
PubMed2000

Alcohol consumption, alcohol dependence, and all-cause mortality.

BACKGROUND: This study examined the effects of alcohol consumption and DSM-IV alcohol dependence on the risk of mortality. METHODS: Data from the 1988 National Health Interview Survey Alcohol Supplement were matched to the National Death Index for the years 1988 to 1995 (baseline n = 37,682 U.S. adults age > or =25 linked to 3,586 deaths). All mortality analyses were based on proportional hazards models that adjusted for age, sex, race/ethnicity, marital status, education, income, labor force status, body mass index, smoking status, and poor health indicators at baseline. RESULTS: When dependence was not considered and all past-year abstainers were used as the reference group, both light and moderate drinkers exhibited a reduced risk of mortality, with hazards ratios of 0.76 (0.68-0.84) and 0.84 (0.74-0.96). Heavy drinkers had about the same risk of dying as did past-year abstainers, and very heavy drinkers had an increased risk that was not significant (OR = 1.17, CI = 0.93-1.47). When lifetime abstainers were used as the reference category, the protective effect of moderate drinking fell short of significance, and there were nearly significant increased risks among former drinkers and very heavy drinkers. When dependence was considered, light and moderate drinkers without dependence had a reduced mortality risk regardless of reference group, and there was no significant effect among heavy or very heavy drinkers without dependence. Among dependent drinkers, there was no protective effect of light or moderate drinking, and very heavy drinkers had a significantly increased risk (OR = 1.56 relative to past-year abstainers and 1.65 relative to lifetime abstainers). CONCLUSIONS: Because alcohol dependence nullifies the protective effect of light and moderate drinking, it is important to understand its role as an independent risk factor for mortality. Differences between dependent and nondependent drinkers who drank comparable amounts suggest that this risk may result from longer and heavier drinking histories before baseline, more severe health problems at baseline, more heavy episodic drinking, and, possibly, differences in beverage preference.

Adult↗
PubMed2000

Gender-specific differences in the natural history, clinical features, and socioeconomic status of HIV-infected patients: experience of a treatment centre in Vienna.

BACKGROUND: In order to evaluate natural history, clinical features, and socioeconomic aspects in HIV-infected women, a prospective study comprising 695 HIV-infected patients was performed at our department. METHODS: Demographic data, CD4+ T-lymphocyte counts, human immunodeficiency virus-1 (HIV-1) plasma loads, AIDS indicator diseases and socioeconomic variables were recorded. Prognostic factors for survival were evaluated by univariate and multivariate analysis. Data of men and women were compared. RESULTS: The mean age of the 150 women (29.4 +/- 9.4 years) was significantly lower than that of men (32.6 +/- 9.7 years, p = 0.0002). CD4+ T-lymphocyte counts, HIV1-plasma loads, and AIDS indicator diseases did not significantly differ between men and women; the same was true for all socioeconomic variables (family status, education, professional training, employment status) except family status. No significant difference in median overall and AIDS-free survival was observed between females (2033 and 1593 days) and males (1554.5 and 1235 days, respectively, p = 0.36 and p = 0.098). Overall survival compared by age groups (< 30, 31-50, > 50 years), by risk categories (homosexuals, i.v. drug users, heterosexual contacts) and by CD4+ T-lymphocyte count (< 200, 200-500, > 500 cells/mm3), differed significantly (p < 0.001) as did AIDS-free survival. Lower age and a high CD4+ T-lymphocyte count were independently associated with the outcome in the multivariate analysis. (Overall survival/relative risk: 0.49 for age < 30 years and 2.3 for CD4+ T-lymphocyte count < 200 cells/mm3, AIDS-free survival/relative risk: 0.65 for age < 30 years and 3.3 for CD4+ T-lymphocyte count < 200 cells/mm3). HIV-1 plasma loads as a prognostic factor could not be evaluated due to the small number of patients who died or developed AIDS (2/375 and 10/375 patients, respectively). CONCLUSION: Our results showed no difference in the natural history and clinical features of HIV infection between men and women. However, pulmonary tuberculosis was associated with a significantly longer survival compared to other AIDS-defining diseases. Lower age and high CD4+ T-lymphocyte count are independent predictors for survival. With the exception of family status, socioeconomic variables showed no differences between male and female patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Demographic and clinical factors as determinants of serum levels of prostate specific antigen and its derivatives.

BACKGROUND: To characterise the association between demographic and clinical factors and levels of total prostate specific antigen (tPSA) and its molecular derivatives complexed PSA (cPSA), free PSA (fPSA) and the ratio of free to total PSA (%fPSA)] in New Zealand Maori, Pacific Islanders and Europeans, in order to determine whether reported ethnic differences in PSA can be explained by lifestyle and social factors. MATERIALS AND METHODS: Demographic and clinical factors were examined in relation to tPSA, fPSA and cPSA levels, in 1405 Maori, Pacific Island and New Zealand European men with no clinical evidence of prostate cancer, in the Wellington region of New Zealand. Any associations between levels of PSA and PSA derivatives and body mass index, smoking status, family cancer history, non-steroidal anti-inflammatory/vitamin supplement usage, number of sexual partners, age at first intercourse, previous vasectomy, marital/partnership status, educational level and socioeconomic status were investigated by backwards stepwise regression analysis, correcting for age, ethnicity and urinary symptoms. RESULTS: Not being married/partnered was associated with increased tPSA, fPSA and cPSA. tPSA and cPSA decreased with regular non-steroidal anti-inflammatory use. cPSA was decreased in subjects with a first degree relative with any form of cancer. tPSA and fPSA were decreased if the body mass index was > 34. fPSA and %fPSA were decreased in current and former smokers. CONCLUSION: Demographic and clinical factors appear to have a significant effect on levels of PSA and its various derivatives and may account for previously observed ethnic differences. It is important that these associations are taken into account when comparing individual PSA results with standard reference ranges.

Adult↗
PubMed2005

Dental check-ups in 31-year-olds in relation to optimism and life satisfaction.

OBJECTIVE: To analyse the impact of optimism and life satisfaction on dental check-ups. BASIC RESEARCH DESIGN: A cross-sectional study. PARTICIPANTS: The data used in this study consists of a postal questionnaire sent to the members of the 1966 Birth Cohort in Northern Finland. The number of replies totalled 8,690, giving a response rate of 75.3%. MAIN OUTCOME MEASURES: The subjects were classified into two categories according to frequency of dental check-ups: those who went for check-ups at least once in two years and those who went more rarely. A Life Orientation Test was used to measure optimism. Life satisfaction was measured using a single question. The other explanatory variables were gender, marital status, education, incomes and employment status. Multivariate analyses were performed using log-binomial regression models. RESULTS: Independent of other factors, life satisfaction among women and optimism among men was associated with dental check-ups. Links between socioeconomic factors and dental check-ups were weaker than anticipated. CONCLUSIONS: The results suggest that not only socioeconomic factors but also psychosocial aspects need to be taken into account in planning successful dental health policy.

Adult↗
PubMed2006

Effects of socio-economic and behavioural characteristics in explaining central obesity--a study on adult Asian Indians in Calcutta, India.

The present cross-sectional study on adult Asian Indians in Calcutta, India was undertaken to look into the effects of socio-economic and behavioural characteristics in explaining waist-hip ratio (WHR). A total of 500 apparently healthy individuals (300 men and 200 women) were subjects in the study. A random sampling procedure using local voter's registration list was followed to select the subjects. Only one adult (> or = 30 years) from each household was considered as participant. A total of 24 items, 14 socio-economic and 10 behavioural characters were considered. For socio-economic characters, a number of items namely employment status, types of occupation, education status, nature of housing and marital status were taken into consideration. Smoking status, physical exercise by means of outdoor activity, drinking habits and diets on the other hand were considered as behavioural characters. Information on socio-economic and behavioural characteristics was collected using an open-ended schedule specifically designed in this regard. Anthropometric measures namely height, weight and circumference of waist and hip were obtained from participants using standard techniques. The median WHR for men and women was 0.94 and 0.90 respectively. Analysis of variance revealed significant sex difference for all anthropometric measures. It was observed that more women were leading sedentary (outdoor activity not housework was considered) life than men (85.4% vs. 75.4%). Furthermore, women were predominantly nonsmokers (98.8%) whereas 40.2% men were smokers as against 51.4% ex-smokers (those who have quitted smoking during past two years). Multiple regression analysis (adjusted for age and sex) of WHR by socio-economic and behavioural characters revealed that occupation, housing, marital status, smoking condition, physical exercise, drinking habits and diets pattern cumulatively explains 75% (R2=0.75) of total variation of WHR in the study population.

Adult↗