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PubMed2002

Advances in oral health knowledge of Greek navy recruits and their socioeconomic determinants.

BACKGROUND: The aim of the present study was to evaluate temporal changes on oral health knowledge and attitudes among two populations of young Greek males (age 19-29 years) undergoing their military training. A secondary aim was to identify socioeconomic trends that may have influenced the above. METHODS: A total of 2,764 healthy subjects (1511 in 1985, and 1253 in 1996) answered a standardized questionnaire of oral health issues. Respondents were stratified in 3 groups, according to their educational status (ES); their responses were compared using the chi-square statistic. The evaluation of socioeconomic indicators utilized longitudinal data from the national Household Expenditures Survey. RESULTS: An overall improvement was noted in the majority of "Knowledge" and "Attitudes" variables in 1996, as compared to 1985. Education seems to play an important role in both knowledge and attitudes. These changes may also be partially attributed to a shift in consuming standards from the coverage of main needs to income disposal directed towards the achievement of better quality of life.

Journal Article↗

PubMed2002

Male breast carcinoma.

OBJECTIVE: To review the epidemiology, presentation, diagnosis, molecular genetics, treatment and prognosis of male breast cancer. DATA SOURCES: Articles, written in English or French, selected from the Medline database (1966 to January 2001), corresponding to the key words "male breast cancer," according to the following criteria: covering institutional experience or comparing diagnostic and treatment modalities, and epidemiologic or general reviews. STUDY SELECTION: Of 198 articles found 50 fulfilled the review criteria. DATA SYNTHESIS: Risk factors included advanced age, a positive family history, Jewish origin, black race, excess exposure to female hormones (Klinefelter's syndrome), environmental exposure (irradiation), alcohol, obesity, higher socioeconomic or higher educational status and childlessness. Gynecomastia remains a controversial factor, this term being used for both a histologic reality and a physical finding. Advanced disease is characterized by pain, bloody discharge and skin ulceration. There is no definitive diagnostic algorithm. Experience with male breast mammography is limited, and imaging is less informative for patients under 50 years of age. Fine-needle aspiration tends to overestimate the rate of malignancy. The commonest histologic finding is infiltrating ductal adenocarcinoma. Treatment includes modified radical mastectomy, followed by cyclophosphamide-methotrexate-5-fluorouracil or 5-fluorouracil-Adriamycin-cyclophosphamide chemotherapy for disease of stage II or greater. Radiotherapy does not seem to add any benefit. The disease is highly receptor-positive; however, many patients discontinue tamoxifen due to side effects. The most important prognostic factors are tumour size, lymphatic invasion and axillary node status. CONCLUSIONS: Because of the low incidence of male breast cancer, advances will be obtained mainly with the rapid transfer of newly gained knowledge in female mammary neoplasia. The increased use of adjuvant chemotherapy combined with tamoxifen postoperatively may have a positive impact on survival. Public education should be oriented toward men at higher risk to reduce the interval between appearance of symptoms and consultation. Rigorous data collection will allow for thorough reporting of risk factors and thus the possibility of characterizing the etiology of this disease.

Algorithms↗

PubMed2003

Prevalence of cigarette smoking in young Nigerian females.

Cigarette smoking is a very important public health problem globally, with patterns of smoking varying in different regions of the world. The negative impact of smoking on health is well known but the increasing rate of smoking amongst the youth including females is note worthy. The objective of this study is to determine the prevalence of smoking in young Nigerian females with a view to defining the size of this social problem and outlining possible control measures. The setting for the study was secondary (post-primary) schools in Anambra State, South east of Nigeria. The study, a cross-sectional survey, involved eight (8) schools selected by multistage sampling technique. A Structured questionnaire was designed for the study. A total of 1,200 female secondary school students were involved. The mean age of the respondents was 16.06 +/- 1.36 years. The main religious denominations were Roman Catholic 69.7%, Anglicans 23.6%, Pentecostal 5.7%, Islam 0.4% and others 0.4%. Ninety two point seven percent (92.7%) were single, 2.9% were married and 4.4% engaged. Fifty seven point four percent (57.4%) were day students while 42.6% were boarders. Smoking prevalence was 7.7%. Smoking was started at the mean age of 12.6 +/- 3.8 years. The number of cigarettes smoked per day has a median of 2 sticks, Marital status significantly affected smoking prevalence as the married had more tendency to smoke than the unmarried. Though the number of day students who smoked were more than the boarders, the significance could not be demonstrated statistically due to the small number of subjects who smoke. Parents educational status did not show any significant influence on the smoking habit. We conclude that the prevalence of cigarette smoking in young Nigerian females is relatively low. Intervention at this stage will be timely but effective strategies to curb the habit will require identification of other factors that may be contributing to the social menace.

Adolescent↗

PubMed1986

Correlates of accurate knowledge of cancer.

Knowledge acquisition, although a prerequisite of preventive behavior, has been a neglected area of research. Mass communication research shows that audience characteristics explain most of the variation in knowledge acquistion. Since cancer information is mainly disseminated via the media, we hypothesized that the same audience characteristics would be related to accuracy of cancer knowledge. Bivariate and multivariate associations between the hypothesized variables and a cancer knowledge score were tested using a three-stage random sample of Los Angeles County (N = 931). Smoking status, education, degree of cancer worry, health improvement behavior, ethnicity, age, household size, and frequency of health worry were related to knowledge accuracy. An examination of the underlying dimensions of cancer knowledge revealed three beliefs about cancer: smoking causes cancer; cancer can be cured; and the environment does not cause cancer. Smoking status, ethnicity, health improvement behavior, and worry about cancer and health were associated with the belief that smoking causes cancer. The independent variables in this study were not significantly related to the other two beliefs. These results conform with the general predictions of mass communication research. We conclude that targeting of cancer information and particular uses of media could raise the general level of cancer knowledge.

Adolescent↗

PubMed2005

Prediction of social activity 1 year poststroke.

OBJECTIVE: To develop an easy-to-use prediction rule for social activity 1 year poststroke that can identify patients at risk for social inactivity. DESIGN: Inception cohort. SETTING: Rehabilitation center. PARTICIPANTS: Patients with a first-ever supratentorial stroke were selected in 4 Dutch rehabilitation centers. Data of 250 patients were available for analysis. Potential prognostic factors measured at admission were sex, age, marital status, prestroke employment status, educational level, type of stroke, hemisphere, motor impairment, trunk control, communication, and activities of daily living (ADL) dependency. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Social activity measured by the Frenchay Activities Index (FAI) at 1 year poststroke. RESULTS: Multivariate backward linear regression analysis identified sex, age, marital status, motor impairment, communication, and ADL dependency as important predictors of the FAI score 1 year poststroke. An easy-to-use score chart was constructed that could identify patients at risk for social inactivity. The score chart proved to be well able to discriminate poor social functioning from moderate to good social functioning (area under the curve = .85). CONCLUSIONS: Identifying patients at risk enables health care professionals to focus on the social activity of this patient subgroup at an early stage in the care process.

Activities of Daily Living↗

PubMed1996

Function and medical comorbidity in south Texas nursing home residents: variations by ethnic group.

OBJECTIVE: To evaluate differences in functional status and burdens of medical conditions in Mexican American and non-Hispanic white nursing home residents. DESIGN AND SETTING: Cross-sectional survey of 17 nursing homes in south Texas. PARTICIPANTS: A total of 617 older nursing home residents, of whom 366 were Mexican American and 251 were non-Hispanic white. MEASURES: Activities of Daily Living (ADL) status abstracted from standard nurses notes and Burden of Disease abstracted from medical records. RESULTS: Mexican American residents had greater numbers of ADL dependencies and poorer overall ADL scores than non-Hispanic white residents. This poor functioning was not explained by age, gender, or marital or educational status. The average number of medical conditions was greater, and specific conditions, such as cerebrovascular disease, recent acute infections, diabetes, hypertension, and anemia, were more common in Mexican American residents compared with non-Hispanic white residents. In models relating function with medical conditions and ethnic group, ADL scores and dependencies were significantly related to bowel and bladder incontinence, cerebrovascular disease, dementia, recent infections, and skin decubiti, but not to ethnic group. CONCLUSION: Mexican American nursing home residents are more functionally dependent than non-Hispanic white residents. The difference in function is explained by a greater burden of medical conditions in the Mexican American residents.

Activities of Daily Living↗

PubMed2004

Social factors associated with chronic depression among a population-based sample of women in rural Pakistan.

OBJECTIVE: Previous studies have reported a high prevalence of depression in women in Pakistan. This paper investigates whether risk factors for chronic depression established in studies performed in Western countries can explain this high prevalence. METHOD: A two-phase survey using the self-rating questionnaire (SRQ) for common mental disorders and the Psychiatric Assessment Schedule was performed on a general population sample in rural Pakistan. Demographic data and results of the Life Events and Difficulties Schedule were analysed in relation to SRQ score and psychiatric disorder. RESULTS: A total of 145 women were screened. High SRQ score was associated with low educational status, not having a confidant, having four or more children, being older, not being married and living in a house with more than three people per room. Regression analysis demonstrated that the first three of these independently contributed to SRQ score. In the interviewed sample (74 women), only educational level independently contributed to the presence of depression. In addition, the least educated group experienced the greatest number of marked difficulties: 67% of them had experienced both marked housing and financial difficulties compared to 28% and 25% of the other educational groups (p = 0.005). Experiencing both housing and financial difficulties was a significant risk factor for depression in women with secondary education, but not for those without secondary education. CONCLUSIONS: This study suggests that high levels of social adversity and low levels of education are strongly associated with depression in women in Pakistan. The other vulnerability factors found in the West (such as lack of a confidant, the presence of three or more young children at home, or loss of mother during childhood) may be of lesser importance in this population.

Adolescent↗

PubMed2004

What we do and don't know about 'race', 'ethnicity', genetics and health at the dawn of the genome era.

A true understanding of disease risk requires a thorough examination of root causes. 'Race' and 'ethnicity' are poorly defined terms that serve as flawed surrogates for multiple environmental and genetic factors in disease causation, including ancestral geographic origins, socioeconomic status, education and access to health care. Research must move beyond these weak and imperfect proxy relationships to define the more proximate factors that influence health.

Ethnicity↗

PubMed1996

Tobacco, alcohol, and oral cancer: the patient's perspective.

It is well known that smoking, chewing tobacco, and alcohol play a significant role in the etiology of oral cancer. Although this is common knowledge in the medical community, it appears that patients are not aware of this association. We performed a prospective study on all patients newly diagnosed with oral cancer and a control group without any head and neck cancer. Patients completed a questionnaire assessing their awareness of these causative factors. Other parameters measured as possible influences of patient perception included patient age, sex, smoking status, education level, occupation, and place of residence. Patients were also questioned about their knowledge of the causes of lung cancer to allow for comparison. A total of 134 patients were questioned, with 22 of the patients assigned to the oral cancer group and the second group being comprised of 112 patients without head and neck cancer. Only 20 patients (14.9%) were aware of the causative factors of oral cancer. There was no significant difference in the knowledge of causation when comparing the cancer and control group. The patient age, sex, smoking status, or place of residence did not affect their knowledge of the causes of oral cancer. There was a highly significant difference between patients of different education levels and occupations, with the more educated and higher level occupations being better informed about the causes of oral cancer. In contrast, the majority of patients were aware of smoking as a causative factor in the development of lung cancer. The results from this study demonstrate a serious lack of knowledge in the general population of known causes of oral cancer. The relevant issues are discussed and recommendations are made.

Adolescent↗

PubMed1996

Quality of life following coronary bypass surgery.

Quality of Life (QL) following coronary bypass surgery (CABG) can be modified by medical and non-medical factors (i.e., functional class, medical therapy, psychological changes, economic status, educational level, return to work, country origin). The aim of this study was to evaluate QL in 203 patients that underwent CABG (Group A). QL perception was assessed by 5 questionnaires self-rated by the patient. Data obtained by surgical series were compared with 107 patients with coronary artery disease and treated medically (Group B), and a population of 102 normal subjects (Group C). Our findings demonstrated that general well-being, functional status and social participation improved in Group A. Sexual activity decreased in Group A. CABG did not modify job satisfaction. Chest pain was the main variable influencing negatively return to work; age, work before CABG, low educational level and country area were negatively related non medical variables. Work resumption rate decreased significantly in patients over 50 years, in those coming from the south of Italy and also with low educational level.

Age Factors↗

PubMed1996

Urbanisation, household composition and the reproductive health of women in a South African city.

Post-apartheid South Africa is faced with the effects of a distorted urbanisation process. A coherent response to urbanisation includes the mitigation of the adverse health effects of urbanisation. Women, by virtue of the stringent control of their movements to urban areas under apartheid, have migrated to the urban areas at an increasing rate recently. One consequence has been the transformation of traditional household structures consonant with changing patterns of fertility and infertility in the urban areas. This paper describes the composition of households in Khayelitsha, South Africa, a suburb that has seen an explosive increase in population over a 5-year period, from 5000 to an estimated 250,000 people. A survey of 659 households revealed the woman-headed households increased from 11% in those women who had been in the urban areas for fewer than 5 years, to 35% in those who had been in the urban areas for more than 20 years. This was not a function of widowhood or divorce, but appears to be an adaptive strategy adopted by women in the face of gender oppression in a harsh urban environment. The study also revealed the phenomenon of "alliance" household formation, in which atypical households made up of a variety of non-descript combinations of people provide support for women from remote rural areas, another adaptive strategy. Fertility was related to age, income, education and urbanisation. Women who had been in the urban areas for longer than 10 years had a total fertility rate (TFR) of 2.5, while those who had been in the urban areas for less than 10 years had a TFR of 5.8. Reported infertility was related to marital status, education, gynaecological illness and urbanisation, with recently urbanised women reporting more infertility. This probably reflects the different expectations of rural women and changes the mix of attitudes to fertility in the urban areas substantially. These findings have major implications for population policies in South Africa and an eclectic mix of approaches, including small area-specific approaches, to family spacing is recommended.

Adolescent↗

PubMed1989

The nutritional status of children in an urban squatter community in Malaysia.

An anthropometric assessment was conducted on a sample of 309 children, aged twelve years and below, from an urban squatter community in Kuala Lumpur, Malaysia. The community consists mainly of Malays and Indians and is fairly established with a mean length of residence of about fifteen years. There was not much difference between the two ethnic groups with regard to educational status or income. Most of the residents were unskilled or semiskilled workers employed in factories and government agencies. About 40 percent of the infants and toddlers were found to be wasted, while about one-third of the older children were stunted. There appears to be some association between income per capita and nutritional status.

Anthropometry↗

PubMed2003

Chronic neck pain of traumatic and non-traumatic origin: a population-based study.

Chronic neck pain is a common cause of disability. The effect of neck trauma on the development of chronic neck pain has been debated. In this population-based study, 8,356 persons (25-79 years) were randomly selected from a geographically well-defined area in northern Sweden. 6000 answered a self-administered questionnaire. We evaluated the data from all participants in the age range 25-64 years, a total of 4,392 persons. 18% reported chronic neck pain, defined as continuous pain of more than 6 months duration. 5% had a history of neck trauma and 13% had no such history. Of all patients with chronic neck pain, 30% had a history of neck injury. We divided all subjects with a chronic neck pain into two groups: those with or without a history of neck trauma. When studying the effect of sociodemographic data, self-perceived health and working conditions, multiple regression analysis showed that the trauma group consisted of significantly more younger men, who were more frequently on sick-leave and that their perceived health was worse than those without a neck injury. We found no significant differences concerning BMI, marital status, educational level, smoking habits, psychosocial work situation on the Karasek questionnaire or physical activity during leisure time or at work.

Adult↗

PubMed1999

Professional preparation of elementary teachers in Ohio: status of K-6 health education.

Improving the health status of children and youth depends to an extent on the adequate preparation of elementary teachers to teach health education. This survey: 1) examined the status of health education preparation that preservice elementary education majors receive from Ohio colleges and universities (n = 50); 2) determined the type of health education courses that Ohio colleges and universities require for elementary education majors; and 3) assessed the extent to which Ohio colleges and universities incorporate health and pedagogy-related content in their courses for elementary education majors. Results showed that 40 of the 50 institutions offered a health course. Twelve different textbooks were used in the courses. Coverage of course content ranged from much to none for 10 survey items ranging from the National Health Education Standards to the K-6 Health Instruction Responsibilities and Competencies.

Curriculum↗

PubMed2003

Pregnancy loss in the Philippines.

In this cross-sectional study, 8,481 women aged 15-49 who had at least one pregnancy outcome were considered. This study aimed to examine the characteristics of Filipino women having had a pregnancy loss, and to test the association between domestic violence and pregnancy loss. To control for the confounding effect of the number of pregnancies, the sample was divided into seven groups classified by the number of pregnancies. The risk factors considered were demographic characters (age and partner's age, marital status, and place of residence), socioeconomic status (education and partner's education, having a paid helper at home, having a say in how income was spent), domestic violence (physical abuse and forced sex), sexual behavior of partner, whether the pregnancy was wanted, and disease history (tuberculosis, diabetes, hypertension, malaria, hepatitis, kidney disease, heart disease, anemia, goiter and other medical problems). The major risk factors were found to be physical abuse, region, faithfulness of partners, hypertension, hepatitis, kidney disease, anemia, and the other medical problems, respectively. The risk of pregnancy loss for the women suffering domestic violence was 1.59 (95% CI 1.28-1.97) times higher than for the women who did not. Women aged 15-19 years had a much higher risk of pregnancy loss than the other age groups (OR = 1.49, 95% CI 1.22-1.82). There were similar risk for women aged 20-24 years (OR = 1.08, 95% CI 0.94-1.25) and 35-39 years (OR = 1.05, 95% CI 0.92-1.19). No association emerged with marital status, socioeconomic status, forced sex, the number of partners, unwanted pregnancy, tuberculosis, diabetes, malaria, heart disease, and goiter. Although women's age, partner's age, residence, women's education, partner's education, and paid helper at home were significantly associated with pregnancy loss, they were likely to be confounders rather than risk factors.

Abortion, Spontaneous↗

PubMed1996

Nonsteroidal antiinflammatory drug use and cognitive function in the elderly: inconclusive results from a population-based cohort study.

As part of the cohort Paquid, we studied the relationship between the use of NSAID, incidence of dementia, and evolution of cognitive functions. Dementia was diagnosed by DSM-III criteria and cognitive functions was assessed through the Mini-Mental Status Examination (MMSE). During 2 years of follow-up, the incidence rate of dementia was 3.84% among 53 NSAID users as compared with 3.77% in 1199 nonusers (OR, 0.98; 95% CI, 0.23-4.16). Using a cutoff of -3 points for the MMSE score and taking into account age and educational status in a logistic regression model, NSAID use was related to an unfavourable variation of the MMSE score (OR, 2.84; 95% CI, 0.99-8.1).

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1993

The status of elderly women in families viewed from the rate of their heading the household.

The author assesses the socioeconomic status of elderly women in China, with a focus on marital status, educational level, and employment. "In family and population studies, the methodology for research on household head rate is held as superior to household size and generation distribution indexes in understanding the change of family structures. This paper attempts to apply this methodology to the study of elderly women's familial status."

Adult↗

PubMed2000

Smoking status, disease duration, and educational level in females, are related to asthma school participation.

Limited data is available on those who do not want to attend an asthma school. Two hundred and forty-five asthmatics aged 18-65 yrs with an FEV1 >50% predicted who had been seen at our outpatient asthma clinic within the last 3 yrs were invited to participate in an asthma school. The patients were contacted by phone by a nurse, offered a 2 day asthma school without personal costs. Altogether 78% of those contacted answered positively. In a logistic regression analysis including sex, age, smoking status, educational level, asthma duration and own opinion of the disease, the-adjusted odds ratio (OR) for nonsmokers wanting to participate versus smokers was 4.0 (95% confidence interval (CI): 1.8-8.3). The corresponding figure for patients with a recent asthma attack was 3.4 (95% CI: 1.5-7.6) compared to those without. For every 10 yr duration of disease the OR for wanting to take part in the asthma school increased by 1.6 (95% CI: 1.0-2.3). When analysing males and females separately, highly educated females were less willing to take part, while an opposite tendency was present in males. In conclusion those interested in taking part in an asthma school were characterized by highly motivated nonsmokers with long duration of disease and with a recent asthma attack, and not being highly educated females.

Adolescent↗