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PubMed1988

The stability of health status in rheumatoid arthritis: a five-year study of patients with established disease.

We employed a health status measure to describe the outcomes of rheumatoid arthritis patients over five years. Of the 410 rheumatoid arthritis patients who were originally administered the Arthritis Impact Measurement Scales (AIMS), 299 completed a follow-up five years later. Data were analyzed using nine health status scales, three components of health status, and an overall arthritis impact item. Results for survivors indicated that there were no clinically important deteriorations in any of these measures. In fact, small improvements on most measures were found. The health status changes were similar for patients originally in a clinical trial and for those receiving routine specialty care. Age was found to positively relate to improvements in psychological status and overall arthritis impact, but we were unable to demonstrate any consistent effects of sex, marital status, education, or disease duration. Our results contrast with other studies that have noted major declines over time in the health status of patients with rheumatoid arthritis. Furthermore, level of education was not a major determinant of morbidity in this group. These results suggest that health status in certain patients with rheumatoid arthritis is more stable than previously thought. This has implications for both clinical practice and clinical research in rheumatology.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Modernization and status change among aged men and women.

This study investigates the differences between the relationship between elderly occupational status and modernization for men and women. Consonant with previous findings, it finds that economic development is associated with relative losses of elderly men in professional and technical occupations. Augmenting those findings, however, it finds an even stronger association between development and such losses for women. In accounting for the differences, several explanations are advanced and tested, using data from fifty-one nations.

Aged↗
PubMed1987

Profile of Danish women undergoing reversal of sterilization, 1978-1983.

To help identify those women who might regret undergoing sterilization, the Danish women refertilized from 1978 to 1983 were contacted by mailed questionnaire. Eighty-three percent (120/144) responded. These women were younger at the time of sterilization than Danish women sterilized in the same period (mean age 29 years versus 34 years). Furthermore, they had more children at the time of sterilization and had their first and last child at a younger age than Danish women generally, in the same age group. Their social and educational status was lower than the background population and fewer were in gainful employment. At sterilization, most of the women were in an emotionally stressful situation (e.g., marital disharmony (78% of the married women), single parenthood (28%), unwanted pregnancy (27%], or had chronic health problems in the family. Alternative contraceptive methods had not been fully explored. Thirty-eight percent complained of late secondary effects attributable to the sterilization, but the main reason for wanting reversal of sterilization was a new partner (75%). The study suggests that the psycho-social situation and contraceptive alternatives should be carefully evaluated in women requesting sterilization, especially in those below the age of 30.

Adult↗
PubMed1988

The aging of China's population: perspectives and implications.

"China's efforts to accelerate the pace of modernization emphasize the promotion of economic development and the reduction of its population growth through the adoption of a one-child per family policy. However, that policy has implications for the eventual aging of the country's population. This article reviews the changes in the status of the elderly, explores the changes in size of the elderly population, and various related social and policy implications." Topics considered include socioeconomic changes, underlying population dynamics, the current situation of the elderly, some international comparisons, implications of aging, planning for support of the elderly, health care, living arrangements and family support, retirement, and the status of the widowed, divorced, and unmarried in the elderly population.

Adult↗
PubMed1987

Patterns of household immigration into South Texas.

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."

Agriculture↗
PubMedDate not supplied

[Migration and oil in Tabasco].

"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)

Americas↗
PubMed1987

[A study on the local marriage network in Korea].

Place of residence has traditionally been an important factor in Korea in mate selection. This study examines the local marriage network in Korean society, its variation by year of marriage, and general characteristics of the married women. Data are drawn from the 1986 national sample survey on the family life cycle implemented by the Korea Institute for Population and Health. Questionnaires were administered to 3013 wives aged 15-64. Major study findings follow. 1) The local marriage rate within the same region by birthplace is strikingly high in Kyongsangdo and Chonla-do. Local marriage rates are 79.5% in both of these regions, 33.5% in Seoul, 35.2% in Busan, 50% in Kyonggi-do, 48.1% in Kangwon-do, and 60.7% in Chungchung-do. 2) The local marriage rate within the same county or the same city be residence before marriage has rapidly been declining in rural areas since 1960. This is largely due to industrialization, urbanization, and better transportation. The marriage rate in rural areas was 62% among marriages in the 1940s, 47.1% in the 1960s, 43% in the 1980s, and 70.9%, 88.4%, and 70.7% respectively in urban areas. 3) The proportion of local marriages within the same city or county is 55.1% among arranged marriages and 72.3% among romantic marriages. 4) Pre-marital employment seems to have some effects on the extent of mate-selection. Wives who worked before marriage were more likely to marry men in the same city or county. The local marriage rate within the same city or county is 63.2% among wives with work experience, and 58.5% among wives without work experience. 5) The more educated the woman, the higher the local marriage rate within the same city or county. 56.6% of those who attended middle school married men in the same city or county as theirs, 61.4% of wives with a high school education, and 76.6% of wives with college or more education. 63.8% of wives who never attended school married men in the same city or county. In summary, restrictions on marriage between couples of different status has been diminishing due to introduction of democratic thought based on freedom and equality; the marriage network has also narrowed due to industrialization, urbanization, migration, and women's higher educational attainment.

Asia↗
PubMedDate not supplied

Project Redirection: evaluation of a comprehensive program for disadvantaged teenage mothers.

An evaluation of Project Redirection, a two-year demonstration program designed to help pregnant teenagers and teenage mothers, shows that teenagers from a comparison group, who were not enrolled in the demonstration program, were significantly more likely than project participants to experience a repeat pregnancy after one year, but that after two years the difference was small and nonsignificant. Likewise, at 12 months into the program, the project participants proved more likely to be using contraceptives, but by 24 months the comparison group had caught up. After one year of participation, the project teenagers were more likely than the others either to be in school or to have graduated (56 and 49 percent, respectively). However, this differential also disappeared by 24 months. Nonetheless, even at that point, project teenagers who had dropped out prior to joining the program and those who had had a repeat pregnancy were more likely to be in school or to have completed school than were similar comparison teens. Project teenagers also were somewhat more likely to have held a job during the two-year period than were teenagers not enrolled in the program. All in all, the evaluation demonstrated that teenagers who participated in the project and remained in it for more than a year had consistently better outcomes in education, employment and repeat pregnancy than any other group had. Comparison teenagers who had never participated in any special program for pregnant teenagers, on the other hand, demonstrated consistently poorer outcomes than any other group.

Adolescent↗
PubMed1994

[Neuroleptic malignant syndrome. Case reports].

Neuroleptic malignant syndrome is a serious adverse reaction of neuroleptic drug therapy, composed of mental status changes, muscular rigidity, hyperthermia, signs of autonomic instability and typical laboratory findings. The syndrome has received increased attention in the scientific literature since 1980; nevertheless some weighty issues regarding clinical symptoms, etiopathogenesis and treatment require additional studies. This paper presents 9 cases of neuroleptic malignant syndrome prospectively observed in 8 inpatients and 1 outpatient with different psychiatric diagnosis. Levenson's diagnostic criteria were fulfilled in 7 cases; the remaining two had slighter symptoms. So neuroleptic malignant syndrome is to be considered a rare but not unusual side effect of neuroleptics. The risk of syndrome doesn't seem to be correlated with chemical class, D2 receptor affinity and total dosage of neuroleptics; a key factor seems instead to be a quick loading rate of neuroleptics. Seven of 9 cases displayed severe changes in mental status (clouding of consciousness that varies from stupor to coma), violent psychomotor excitement and aggressiveness before the onset of the syndrome. Such clinical features seem themselves, in our experience, to be potential risk factors besides reason for an increase of neuroleptic dosage. Neuroleptic malignant syndrome usually is preceded by prodromal signs, the most important appearing the worsening of alterations in consciousness. Symptoms of neuroleptic malignant syndrome usually appear abruptly and in some cases with a dramatic course; they last, in cases with favourable outcome, a few days to two weeks from neuroleptic withdrawal; by far the worst outcome, instead, occurs if diagnosis and drug discontinuation are not carried out early. The first measure in the treatment of neuroleptic malignant syndrome consists of prompt discontinuation of all neuroleptic medications and other psychopharmacological cures, except for benzodiazepines, and institution of supportive therapy; such interventions can resolve the most of cases. Three patients treated with bromocriptine and/or dantrolene didn't display a different duration of clinical symptoms and rate of complications if compared to patients treated with supportive therapy only. Use of bromocriptine or dantrolene, or both, therefore should be considered as a second line of action. In four cases, neuroleptics were reintroduced within few days of recovery; low potency neuroleptics were employed, given low doses which gradually increased: in none of the 4 cases did the patients experience partial or complete recurrence of neuroleptic malignant syndrome.

Adult↗