1. Am J Public Health. 2009 Oct;99(10):1826-32. Epub 2009 Aug 20.

The influence of past unemployment duration on symptoms of depression among young
women and men in the United States.

Mossakowski KN.

Department of Sociology, University of Miami, 5202 University Drive, Coral
Gables, FL 33146, USA. krysia@miami.edu

OBJECTIVES: I examined whether unemployment while looking for a job and being out
of the labor force while not seeking work have distinct effects on symptoms of
depression among young women and men in the United States. I also investigated
whether past unemployment duration predicts depressive symptoms. METHODS: I used 
ordinary least squares regression to analyze data from the 1979-1994 National
Longitudinal Survey of Youth. RESULTS: Cross-sectional results suggested that
current unemployment status and out-of-the-labor-force status were significantly 
associated with depressive symptoms at ages 29 through 37 years. The association 
between being out of the labor force and depressive symptoms was stronger for
men. Longitudinal results revealed that past unemployment duration across 15
years of the transition to adulthood significantly predicted depressive symptoms,
net of demographics, family background, current socioeconomic status, and prior
depressive symptoms. However, duration out of the labor force did not predict
depressive symptoms. CONCLUSIONS: Longer durations of unemployment predict higher
levels of depressive symptoms among young adults. Future research should measure 
duration longitudinally and distinguish unemployment from being out of the labor 
force to advance our understanding of socioeconomic mental health disparities.

PMID: 19696382 [PubMed - indexed for MEDLINE]


2. J Youth Adolesc. 2009 Oct;38(9):1226-39. Epub 2008 Aug 20.

Trajectories of HIV risk behavior from age 15 to 25 in the national longitudinal 
survey of youth sample.

Murphy DA, Brecht ML, Herbeck DM, Huang D.

Health Risk Reduction Projects, Department of Psychiatry, University of
California at Los Angeles, Los Angeles, CA 90025-7539, USA.
dmurphy@mednet.ucla.edu

This study utilized data from the National Longitudinal Survey of Youth to
investigate youth risk trajectories for HIV and factors associated with different
trajectories. The sample (N = 8,208) was 49.2% female, with a mean age of 14.31
(SD = 1.48). A group-based trajectory model was applied, which identified four
distinct trajectories for both males and females: (1) consistently higher sexual 
risk levels, increasing to early adulthood followed by some decrease ("high");
(2) a short period of increase to late teens, followed by a longer period of
decrease ("decreased"); (3) an initially slow increase, with the increase
accelerating by late teens, and a slight decline beginning in early adulthood
("increased"); and (4) consistently lowest levels of sexual risk ("low"). More
African Americans were found among the decreased trajectory group; among the low 
risk group a higher number of youth came from families with parents who spoke a
language other than English. The high-risk group had a higher percentage of
subjects in non-metropolitan areas and highest alcohol use. Among males, being
employed and being in the military were associated with inclusion in the
high-risk group. Results have implications for specializing prevention strategies
for youth with different patterns of sexual risk.

PMCID: PMC2726972 [Available on 2010/10/1]
PMID: 19669902 [PubMed - indexed for MEDLINE]


3. Spine (Phila Pa 1976). 2009 Jun 15;34(14):1519-25.

Musculoskeletal impairments in the Norwegian working population: the prognostic
role of diagnoses and socioeconomic status: a prospective study of sickness
absence and transition to disability pension.

Gjesdal S, Bratberg E, Maeland JG.

Section of Social Medicine, Department of Public Health and Primary Health Care, 
University of Bergen, Norway. sturla.gjesdal@isf.uib.no

STUDY DESIGN: Population-based, 5-year prospective cohort study. OBJECTIVE: To
assess the incidence of musculoskeletal disorders (MSDs) in sickness absence
longer than 8 weeks in Norway, and to identify diagnostic and socioeconomic
predictors of the transition to disability pension (DP). SUMMARY OF BACKGROUND
DATA: MSDs are prevalent and of major concern for sickness absence. Previous
epidemiological studies are largely cross-sectional and based on self-reports,
often with low response rates, selection, and reporting bias. Prospective studies
with physician-verified diagnoses might be a better approach. METHODS:
Thirty-seven thousand nine hundred forty-two females and 26,307 males with an
episode of sickness absence >8 weeks in 1997, certified with a MSD were followed 
up for 5 years. Diagnostic and sociodemographic data were obtained from a
national database. Cases were divided into 9 diagnostic subgroups, based on the
International Classification of Primary Health Care. Survival analysis was
performed with granting of DP as the endpoint, in the full sample and for
diagnostic subgroups. RESULTS: Over all 20% of cases obtained DP during
follow-up. Among those aged 50 to 62 and among those with only basic education
46% obtained DP. DP rates were highest for osteoarthrosis (47%), rheumatoid
arthritis (46%), and myalgia/fibromyalgia (38%). Fractures/injuries had the
lowest rate. Controlled for age, education and income, relative risk of DP was
1.5 (95% CI: 1.4-1.6) for upper limb problems, 2.0 (95% CI: 1.8-2.1) for back
problems, 2.8 (95% CI: 2.5-3.1) for osteoarthrosis, 3.3 (95% CI: 3.0-3.6) for
myalgia/fibromyalgia, and 4.2 (95% CI: 3.9-4.7) for rheumatoid arthritis,
compared to "fractures and injuries." CONCLUSION: Age, diagnoses, and
socioeconomic variables were important predictors of an adverse outcome among
workers with a sickness absence of 8 or more weeks. Further research is needed to
determine whether differentiated follow-up strategies might prevent permanent
disability.

PMID: 19525845 [PubMed - indexed for MEDLINE]


4. BMC Neurol. 2009 Jun 12;9:24.

Psychosocial Outcomes in StrokE: the POISE observational stroke study protocol.

Hackett ML, Glozier N, Jan S, Lindley R.

Neurological and Mental Health Division, The George Institute for International
Health, The University of Sydney, Sydney, Australia. mhackett@george.org.au

BACKGROUND: Each year, approximately 12,000 Australians of working age survive a 
stroke. As a group, younger stroke survivors have less physical impairment and
lower mortality after stroke compared with older survivors; however, the
psychosocial and economic consequences are potentially substantial. Most of these
younger stroke survivors have responsibility for generating an income or
providing family care and indicate that their primary objective is to return to
work. However, effective vocational rehabilitation strategies to increase the
proportion of younger stroke survivors able to return to work, and information on
the key target areas for those strategies, are currently lacking. METHODS/DESIGN:
This multi-centre, three year cohort study will recruit a representative sample
of younger (< 65 years) stroke survivors to determine the modifiable predictors
of subsequent return to work. Participants will be recruited from the New South
Wales Stroke Services (SSNSW) network, the only well established and cohesively
operating and managed, network of acute stroke units in Australia. It is based
within the Greater Metropolitan area of Sydney including Wollongong and
Newcastle, and extends to rural areas including Wagga Wagga. The study
registration number is ACTRN12608000459325. DISCUSSION: The study is designed to 
identify targets for rehabilitation-, social- and medical-intervention strategies
that promote and maintain healthy ageing in people with cardiovascular and mental
health conditions, two of the seven Australian national health priority areas.
This will rectify the paucity of information internationally around optimal
clinical practice and social policy in this area.

PMCID: PMC2708124
PMID: 19519918 [PubMed - indexed for MEDLINE]


5. Arthritis Rheum. 2009 May 15;61(5):667-73.

Predicting depression in rheumatoid arthritis: the signal importance of pain
extent and fatigue, and comorbidity.

Wolfe F, Michaud K.

University of Kansas School of Medicine and National Data Bank for Rheumatic
Diseases, Wichita, Kansas.

OBJECTIVE: To determine the incidence of self-reported depression (SRD) in
rheumatoid arthritis and to identify and rank clinically useful predictors of
depression. METHODS: We assessed 22,131 patients for SRD between 1999 and 2008.
We collected demographic, clinical and treatment data, household income,
employment and work disability status, comorbidity, scales for function, pain,
global, and fatigue, the Regional Pain Scale (RPS), the Symptom Intensity (SI)
scale (a linear combination of the RPS and the fatigue scales) and linear
combinations of the Health Assessment Questionnaire, pain and global severity. We
used logistic regression analyses with multivariable fractional polynomial
predictors, and Random Forest analysis to determine the importance of the
predictors. RESULTS: The cross-sectional prevalence of self-reported depression
was 15.2% (95% confidence interval [95% CI] 14.7-15.7%) and the incidence rate
was 5.5 (95% CI 5.3-5.7) per 100 patient years of observation. The cumulative
risk of SRD after 9 years was 38.3% (95% CI 36.6-40.1%). Almost all variables
were significant predictors in logistic models. In Random Forest analyses, the SI
scale, followed by comorbidity, best predicted self-reported depression, and no
other variable or combination of variables improved prediction compared with the 
SI scale. CONCLUSION: Pain extent and fatigue (SI scale) are the dominant
predictors of SRD. These variables, also of central importance in the
symptomatology of fibromyalgia, are powerful markers of distress. A strong case
can be made for the inclusion of these assessments in routine rheumatology
practice. In addition, actual knowledge of comorbidity provides important
insights into the patient's global health and associated perceptions.

PMID: 19404997 [PubMed - indexed for MEDLINE]


6. Am J Epidemiol. 2009 May 1;169(9):1085-91. Epub 2009 Mar 24.

Changes in perceived job strain and the risk of major depression: results from a 
population-based longitudinal study.

Wang J, Schmitz N, Dewa C, Stansfeld S.

Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary,
Alberta, Canada. jlwang@ucalgary.ca

Comment in:
    Am J Epidemiol. 2009 Jul 1;170(1):131-2; author reply 132-3.

Major depression is a prevalent mental disorder in the working population.
Improving the work environment may reduce the risk of major depression. The
authors examined data from the longitudinal cohort of the Canadian National
Population Health Survey from 1994-1995 to 2004-2005. Survey participants were
classified into 4 groups by changes in job strain status from 1994-1995 to
2000-2001 (no change in low job strain, no change in high job strain, changing
from high to low job strain, and changing from low to high job strain). The
incidence proportion of major depressive episodes in each of the 4 groups was
4.0%, 8.0%, 4.4%, and 6.9%, respectively. Participants who reported a change from
high to low job strain had a risk of major depression similar to those exposed to
persistently low job strain. Among those exposed to persistent high job strain,
only participants who reported good or excellent health at baseline had a higher 
risk of major depression, but those who reported fair or poor health did not.
Reducing job strain may have positive impacts on the risk of depression.
Self-rated health is a strong predictor of depression and plays an important role
in the relation between job strain and depression.

PMID: 19318611 [PubMed - indexed for MEDLINE]


7. Soc Sci Med. 2009 May;68(9):1676-84. Epub 2009 Mar 14.

Does health predict the reporting of racial discrimination or do reports of
discrimination predict health? Findings from the National Longitudinal Study of
Youth.

Gee G, Walsemann K.

UCLA, Community Health Sciences, 650 Charles E. Young Dr. South, Los Angeles, CA 
90024, USA. gilgee@ucla.edu

Racial discrimination may contribute to diminished well-being, possibly through
stress and restricted economic advancement. Our study examines whether reports of
racial discrimination predict health problems, and whether health problems
predict the reporting of racial discrimination. Data come from years 1979 to 1983
of the US National Longitudinal Study of Youth, focusing on respondents of Black 
(n=1851), Hispanic (n=1170), White (n=3450) and other (n=1387) descent. Our
analyses indicate that reports of racial discrimination in seeking employment
predict health-related work limitations, although these limitations develop over 
time, and not immediately. We also find that reports of discrimination at two
time-points appear more strongly related to health-related work limitations than 
reports at one time-point. A key finding is that these limitations do not predict
the subsequent reporting of racial discrimination in seeking employment. These
findings inform our knowledge of the temporal ordering of racial discrimination
in seeking employment and health-related work conditions among young adults. The 
findings also indicate that future research should carefully attend to the
patterns and timing of discrimination.

PMID: 19289253 [PubMed - indexed for MEDLINE]


8. Clin J Am Soc Nephrol. 2009 Mar;4(3):645-50. Epub 2009 Mar 4.

The comprehensive dialysis study (CDS): a USRDS special study.

Kutner NG, Johansen KL, Kaysen GA, Pederson S, Chen SC, Agodoa LY, Eggers PW,
Chertow GM.

Rehabilitation/Quality of Life Special Studies Center, United States Renal
DataSystem, Emory University, Atlanta, Georgia, USA.

BACKGROUND AND OBJECTIVES: The Comprehensive Dialysis Study (CDS) aimed to
understand factors contributing to physical, functional, and nutritional health
status among patients starting dialysis. DESIGN, SETTING, PARTICIPANTS, &
MEASUREMENTS: A phone interview survey was conducted with patients from a
geographically stratified national random sample of dialysis units, and quarterly
serum samples were obtained for patients at a preidentified subset of units. The 
phone survey collected standardized measures of physical activity, employment and
disability status, perceived health and well-being, and dietary intake. Serum
samples were obtained to measure prealbumin, albumin, creatinine, normalized
protein catabolic rate, and C-reactive protein. To comply with restrictions
required under the Health Insurance Portability and Accountability Act (HIPAA),
dialysis unit personnel could not participate in any research-related activities.
RESULTS: Overall participation rate was 18.5%. One thousand six hundred forty-six
patients affiliated with 295 dialysis units completed the phone survey; 361
patients affiliated with 68 dialysis units also completed a dietary intake
survey, with 269 providing serum samples. Despite challenges in the design and
implementation of CDS, the population was diverse and results should be
generalizable. CONCLUSIONS: Constraints within the dialysis industry and HIPAA
requirements render the assembly of nationally representative cohorts extremely
difficult. Nevertheless, the CDS represents the largest cohort of incident
dialysis patients containing detailed information on self-reported physical
activity and dietary intake and is one of few cohorts simultaneously measuring
laboratory proxies of nutrition and inflammatory status. Data from CDS can be
used to inform the design of interventions addressing several conditions that
affect longevity and health status in ESRD.

PMCID: PMC2653653 [Available on 2010/3/1]
PMID: 19261814 [PubMed - indexed for MEDLINE]


9. Soc Sci Med. 2009 Feb;68(4):708-16. Epub 2009 Jan 10.

Obesity, race/ethnicity and the multiple dimensions of socioeconomic status
during the transition to adulthood: a factor analysis approach.

Scharoun-Lee M, Adair LS, Kaufman JS, Gordon-Larsen P.

Department of Nutrition, Carolina Population Center, University of North Carolina
at Chapel Hill, 123 W. Franklin Street, Chapel Hill, NC 27516, USA.

Racial/ethnic disparities in obesity widen dramatically during young adulthood in
the US. Understanding racial/ethnic differences in the association between
socioeconomic status (SES) and obesity can provide insight on these disparities. 
However, the delay and complexity of the transition to adulthood create
challenges for defining SES using traditional, single indicators, such as income 
or years of education. Our objective was to define a multidimensional measure of 
young adult SES using exploratory factor analysis and to investigate whether
distinct SES dimensions differentially predicted obesity across race/ethnicity in
11,250 young adults (mean age=21.9 years) from the National Longitudinal Study of
Adolescent Health (Wave III: 2000-2001). Four factors (social advantage;
schooling; employment; and economic hardship) extracted from a principal factor
analysis on 38 SES indicators comprised our multidimensional measure of young
adult SES. The respondents' scores on each factor were entered into
gender-stratified Poisson regression models to estimate the relative risk of
young adult obesity for a contrast of approximately one standard deviation in
score. The association of the "Social advantage" and "Economic hardship" factors 
with obesity differed by race/ethnicity (p<0.05 for Wald test of interaction) in 
females; high "Social advantage" scores were inversely associated with obesity in
white and Hispanic females (9-20% lower) while high scores on "Economic hardship"
were positively associated with obesity (7-76% higher) in white and Asian
females. In contrast, no significant racial/ethnic differences were detected in
young adult males. The "Schooling" factor was significantly protective (RR=0.91; 
95% CI: 0.85, 0.98) for females of all racial/ethnic groups. These results
facilitate understanding of the impact of multiple, distinct SES dimensions
during the complex transition to adulthood and thus provide salient information
for reducing racial/ethnic disparities in obesity during this important period
for obesity development.

PMCID: PMC2755235 [Available on 2010/2/1]
PMID: 19136186 [PubMed - indexed for MEDLINE]


10. BMJ. 2009 Jan 8;338:a2981. doi: 10.1136/bmj.a2981.

Outcomes of conduct problems in adolescence: 40 year follow-up of national
cohort.

Colman I, Murray J, Abbott RA, Maughan B, Kuh D, Croudace TJ, Jones PB.

School of Public Health, University of Alberta, 13-130D Clinical Sciences
Building, Edmonton, AB, Canada T6G 2G3. ian.colman@ualberta.ca

Comment in:
    BMJ. 2009;338:b775.

OBJECTIVE: To describe long term outcomes associated with externalising behaviour
in adolescence, defined in this study as conduct problems reported by a teacher, 
in a population based sample. DESIGN: Longitudinal study from age 13-53. SETTING:
The Medical Research Council National Survey of Health and Development (the
British 1946 birth cohort). PARTICIPANTS: 3652 survey members assessed by their
teachers for symptoms of externalising behaviour at age 13 and 15. MAIN OUTCOME
MEASURES: Mental disorder, alcohol abuse, relationship difficulties, highest
level of education, social class, unemployment, and financial difficulties at
ages 36-53. RESULTS: 348 adolescents were identified with severe externalising
behaviour, 1051 with mild externalising behaviour, and 2253 with no externalising
behaviour. All negative outcomes measured in adulthood were more common in those 
with severe or mild externalising behaviour in adolescence, as rated by teachers,
compared with those with no externalising behaviour. Adolescents with severe
externalising behaviour were more likely to leave school without any
qualifications (65.2%; adjusted odds ratio 4.0, 95% confidence interval 2.9 to
5.5), as were those with mild externalising behaviour (52.2%; 2.3, 1.9 to 2.8),
compared with those with no externalising behaviour (30.8%). On a composite
measure of global adversity throughout adulthood that included mental health,
family life and relationships, and educational and economic problems, those with 
severe externalising behaviour scored significantly higher (40.1% in top
quarter), as did those with mild externalising behaviour (28.3%), compared with
those with no externalising behaviour (17.0%). CONCLUSIONS: Adolescents who
exhibit externalising behaviour experience multiple social and health impairments
that adversely affect them, their families, and society throughout adult life.

PMCID: PMC2615547
PMID: 19131382 [PubMed - indexed for MEDLINE]


11. Psychiatr Genet. 2009 Feb;19(1):14-26.

Trajectories of depressive symptoms, dopamine D2 and D4 receptors, family
socioeconomic status and social support in adolescence and young adulthood.

Guo G, Tillman KH.

Carolina Center for Genome Sciences, and Carolina Population Center, University
of North Carolina-Chapel Hill, Chapel Hill, North Carolina 27599, USA.
guang_guo@unc.edu

OBJECTIVES: The purpose of this study is two-fold. First, we tested the
association between dopamine D2 and D4 receptors and a trajectory of depressive
symptoms in adolescence and young adulthood. Second, we reestimated the
association between the dopamine receptors and depression after taking into
account the effects of socioeconomic disparity and child-parent ties and social
support. METHODS: The study uses the DNA sample of approximately 2500 individuals
in the National Longitudinal Study of Adolescent Health (Add Health). Each
individual was measured three times in 1994, 1996, and 2002. RESULTS: This study 
has yielded robust associations of the DRD2 and DRD4 variants with depressive
symptoms among male adolescents and young adults. The DRD2*304/178 genotype is
associated with a level of depressive symptoms 0.04-0.07 points (3-5% of the
mean) higher than the DRD2*178/178 genotype. Relative to the other more common
DRD4 variants, the DRD4*379/379 genotype raises the level of depression by about 
0.25 points (about 17% of the mean). These findings hold after adjusting for the 
effects of socioeconomic status (family structure, parental education, family
income, mother's employment status, and whether attending public school) and
child-parent ties/social support (conflict with parent(s), closeness to
parent(s), parental availability, and social support). Although the gene-sex
interaction is clearly present, the tests of gene-lifecourse interaction did not 
yield any significant results. CONCLUSION: Our findings emphasize the importance 
of joint influences of genetic propensities and social environment on depressive 
symptoms.

PMID: 19125104 [PubMed - indexed for MEDLINE]


12. Soc Sci Res. 2008 Sep;37(3):736-52.

Desistance from delinquency: the marriage effect revisited and extended.

Beaver KM, Wright JP, DeLisi M, Vaughn MG.

College of Criminology and Criminal Justice, Florida State University, 634 West
Call Street, Tallahassee, FL 32306-1127, USA. kbeaver@mailer.fsu.edu

Desistance from criminal offending has become the source of a considerable amount
of research attention. Much of this literature has examined how environmental
factors, such as marriage, employment, and delinquent peers contribute to the
desistance process. A relatively unexplored possibility, however, is that
desistance from criminal behavior is partially due to genetic factors. To test
this possibility, data from the National Longitudinal Study of Adolescent Health 
(Add Health) were used to examine the effects that five different genetic
polymorphisms (DAT1, DRD2, DRD4, 5HTT, and MAOA) have on desistance from
delinquent involvement. Three broad findings emerged. First, marriage
significantly increased desistance. Second, some of the genetic polymorphisms had
significant independent effects on desistance. Third, for males, the genetic
polymorphisms interacted with marital status to predict variation in desistance. 
The findings underscore the importance of using a biosocial perspective to
examine factors related to criminal desistance.

PMID: 19086113 [PubMed - indexed for MEDLINE]


13. Disabil Rehabil. 2009;31(6):484-9.

Financial and vocational outcomes 2 years after traumatic brain injury.

Shigaki CL, Johnstone B, Schopp LH.

Department of Health Psychology, University of Missouri, Columbia, MO 65212, USA.
shigakic@health.missouri.edu

PURPOSE: To determine outcomes for persons with traumatic brain injury (TBI) in
terms of employment status, income and public assistance received at 2 years
after injury. METHOD: This study was part of a non-experimental, longitudinal
survey. Participants included 49 persons with new TBI from one US national
Traumatic Brain Injury Model Systems centre. Main outcome measures included
employment status, earned monthly income and monthly income from public sources, 
at the time of injury and at 2-years follow-up. RESULTS: At 2-year follow-up,
individuals with TBI reported higher levels of employment and earned income than 
was previously reported for 1-year post-injury, but continued to experience
declines relative to pre-injury baseline. Frequency and amount of major public
agency payments continued to be increased relative to baseline. CONCLUSIONS: The 
costs associated with brain injury remain high for individuals, families and
society, as those with TBI move into the more chronic phase of recovery.

PMID: 19034724 [PubMed - indexed for MEDLINE]


14. Soc Sci Med. 2009 Jan;68(1):49-59. Epub 2008 Nov 17.

A multi-group cross-lagged analyses of work stressors and health using Canadian
National sample.

Ibrahim S, Smith P, Muntaner C.

Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, Canada 
M5G 2E9. sibrahim@iwh.on.ca

This article examines the reciprocal relationships between work variables and
health outcomes and if these relationships differ by social class (measured by
occupational grouping). We used longitudinal data from the 1994/95--2002/03
Canadian National Population Health Survey (NPHS). Karasek's work stress
variables were measured in the 1994/95 (cycle 1, time 1), 2000/01 (cycle 4, time 
2) and 2002/03 (cycle 5, time 3) surveys. Analyses were limited to 2556
respondents aged 18-56 at time 1 and who remained in the same social class (as
defined by occupational position) for all the three time points. Work variables
used were job strain ratio, work social support and job insecurity. Health
outcomes used were distress, depression and self-rated health. Multi-group path
analyses were used to investigate the reciprocal relationships between work and
health variables and if these relationships differed by social class. Analyses
controlled for age, gender, marital status and work status. We find there is a
differential burden of work psychosocial factors and health outcomes by social
class. The cross-lagged relationships between work and health depended on the
outcome, social class and time lag. More significant paths from work to health
were observed than reverse paths from health to work. More significant
relationships between work and health were observed for the shorter time lag (2
years) compared to longer time lags (6 years). Low work social support and job
insecurity were more detrimental to health for respondents in lower social class 
positions. Findings from this study highlight the importance of time lag, and to 
some extent social class, in the reciprocal relationships between work and
health.

PMID: 19010577 [PubMed - indexed for MEDLINE]


15. Health Econ. 2009 May;18(5):535-48.

Weight and wages: fat versus lean paychecks.

Han E, Norton EC, Stearns SC.

Institute for Health Research and Policy, University of Illinois at Chicago,
Chicago, IL 60608, USA. eunahan@uic.edu

Past empirical work has shown a negative relationship between the body mass index
(BMI) and wages in most cases. We improve on this work by allowing the marginal
effect of non-linear BMI groups to vary by gender, age, and type of interpersonal
relationships required in each occupation. We use the National Longitudinal
Survey of Youth 1979 (1982-1998). We find that the often-reported negative
relationship between the BMI and wages is larger in occupations requiring
interpersonal skills with presumably more social interactions. Also, the wage
penalty increases as the respondents get older beyond their mid-twenties. We show
that being overweight and obese penalizes the probability of employment across
all race-gender subgroups except black women and men. Our results for the
obesity-wage association can be explained by either consumers or employers having
distaste for obese workers. (c) 2008 John Wiley & Sons, Ltd.

PMID: 18677723 [PubMed - indexed for MEDLINE]


16. J Appl Psychol. 2008 Jul;93(4):849-63.

How the rich (and happy) get richer (and happier): relationship of core
self-evaluations to trajectories in attaining work success.

Judge TA, Hurst C.

Department of Management, Warrington College of Business, University of Florida, 
Gainesville, FL 32606, USA. timothy.judge@cba.ufl.edu

In this study, the authors linked core self-evaluations to job and work success. 
Utilizing a dynamic design from participants in the National Longitudinal Surveys
of Youth (NLSY79), core self-evaluations were hypothesized to predict
individuals' intercepts (starting levels of success), and their growth
trajectories (slope of individuals' success over time) with respect to job
satisfaction, pay, and occupational status. Results indicated that higher core
self-evaluations were associated with both higher initial levels of work success 
and steeper work success trajectories. Education and health problems that
interfere with work mediated a portion of the hypothesized relationships,
suggesting that individuals with high core self-evaluations have more ascendant
jobs and careers, in part, because they are more apt to pursue further education 
and maintain better health.

PMID: 18642988 [PubMed - indexed for MEDLINE]


17. J Stud Alcohol Drugs. 2008 Mar;69(2):266-74.

Early alcohol use, rural residence, and adult employment.

Mink M, Wang JY, Bennett KJ, Moore CG, Powell MP, Probst JC.

Department of Health Sciences, College of Health Professions, Armstrong Atlantic 
State University, Savannah, Georgia, USA.

OBJECTIVE: Rural residence was once perceived as protective regarding youthful
alcohol use and its effects. Our study examined whether the relationship between 
alcohol use in youth and early adulthood and subsequent employment outcomes
differed for rural and urban youth. METHOD: Data from a 20-year panel survey, the
National Longitudinal Survey of Youth 1979, were used to address the association 
between alcohol use between the ages of 17 and 26 and employment outcomes during 
adulthood. Early drinking experiences and misuse symptoms were used as drinking
behavior measures. Rural was defined as living outside any Metropolitan
Statistical Area. Employment outcomes were defined using employment status and
employment quality. Analyses were weighted to reflect the stratified sample
design (N = 8,399). RESULTS: Drinking behaviors did not differ by residence. In
bivariate analysis, alcohol use measures during youth were consistently
associated with working more than 40 hours per week and earning irregular
compensation. For three of seven employment quality measures examined,
interactions between residence and alcohol use were observed in multivariable
analysis. Rural youth were more likely to suffer adverse employment consequences.
CONCLUSIONS: Rural residence does not appear to provide protection from the
effects of drinking during youth on adulthood employment and was associated with 
adverse outcomes. Further research is needed to ascertain whether such
differences stem from different availability of services or other characteristics
of the rural environment.

PMID: 18299768 [PubMed - indexed for MEDLINE]


18. Pediatrics. 2008 Feb;121(2):e246-52. Epub 2008 Jan 8.

Youth in foster care with adult mentors during adolescence have improved adult
outcomes.

Ahrens KR, DuBois DL, Richardson LP, Fan MY, Lozano P.

Department of Pediatrics, University of Washington, Box 354920, Seattle, WA
98195-4920, USA. kahrens@u.washington.edu

OBJECTIVE: The goal of this study was to determine whether youth in foster care
with natural mentors during adolescence have improved young adult outcomes.
METHODS: We used data from waves I to III of the National Longitudinal Study of
Adolescent Health (1994-2002). Individuals who reported that they had ever been
in foster care at wave III were included. Youth were considered mentored when
they reported the presence of a nonparental adult mentor in their life after they
were 14 years of age and reported that the relationship began before 18 years of 
age and had lasted for at least 2 years. Outcomes were assessed at wave III and
included measures of education/employment, psychological well-being, physical
health, and participation in unhealthy behaviors as well as a summary measure
representing the total number of positive outcomes. RESULTS: A total of 310 youth
met the inclusion criteria; 160 youth were mentored, and 150 youth were
nonmentored. Demographic characteristics were similar for mentored and
nonmentored youth. Mentored youth were more likely to report favorable overall
health and were less likely to report suicidal ideation, having received a
diagnosis of a sexually transmitted infection, and having hurt someone in a fight
in the past year. There was also a borderline significant trend toward more
participation in higher education among mentored youth. On the summary measure,
mentored youth had, on average, a significantly greater number of positive
outcomes than nonmentored youth. CONCLUSIONS; Mentoring relationships are
associated with positive adjustment during the transition to adulthood for youth 
in foster care. Strategies to support natural mentoring relationships for this
population should be developed and evaluated.

PMID: 18182469 [PubMed - indexed for MEDLINE]


19. Work. 2007;29(3):233-8.

Does self-efficacy predict return-to-work after sickness absence? A prospective
study among 930 employees with sickness absence for three weeks or more.

Labriola M, Lund T, Christensen KB, Albertsen K, Bültmann U, Jensen JN, Villadsen
E.

National Institute of Occupational Health, Copenhagen, Denmark. mla@ami.dk

AIM: To compare levels of self-efficacy among the general working population and 
employees with sickness absence from work, and to examine if general
self-efficacy measured before occurrence of sickness absence predicted subsequent
onset of sickness absence and Return-to-Work. METHODS: The study follows a cohort
of 5357 working employees and 106 long-term sickness absent employees in Denmark.
They were interviewed in 2000 regarding self-efficacy and various co-variates,
and followed for 78 weeks in a national sickness absence register. Cox regression
analysis was performed in order to assess the effect of self-efficacy on
Return-to-Work after sickness absence. RESULTS: General self-efficacy was
significantly lower among those with sickness absence compared to the general
working population. Self-efficacy showed no statistically significant association
with later onset of sickness absence or with Return-to-Work. CONCLUSION: The
results may suggest that lower self-efficacy among employees with sickness
absence is a result of the sickness absence itself rather than a precursor of it.
This indicates a need to investigate the potential change in self-efficacy in
relation to the employee's change in labor market status; this will help to focus
Return-to-Work interventions where planning has to be attentive towards the
change in self-efficacy that can occur after onset of disease and sickness
absence.

PMID: 17942994 [PubMed - indexed for MEDLINE]


20. Health Rep. 2007 Aug;18(3):9-24.

Smoking bans: influence on smoking prevalence.

Shields M.

Health Information and Research Division, Statistics Canada, Ottawa, Ontario, K1A
0T6. Margot.Shields@statcan.ca

OBJECTIVES: This article reports trends in smoking prevalence and smoking
restrictions in Canada since 2000, and examines associations between home and
workplace restrictions and smoking cessation. DATA SOURCES: Data are from the
Canadian Tobacco Use Monitoring Survey and the longitudinal component of the
National Population Health Survey. ANALYTICAL TECHNIQUES: Trends in smoking
prevalence and smoking restrictions were calculated. Associations between home
and workplace smoking restrictions and smoking cessation were examined in the
context of the Transtheoretical Model, which proposes that smokers go through
five distinct stages in attempting to quit. The likelihood of current and former 
smokers being at specific stages was studied in relation to smoking restrictions 
at home and at work. Longitudinal data were used to determine if home and
workplace smoking restrictions were predictors of quitting over a two-year
period. MAIN RESULTS: Since 2000, Canadians smokers have faced a growing number
of restrictions on where they can smoke. Bans at home and at work were associated
with a reduced likelihood of being in the initial "stages of change," and an
increased likelihood of being in the latter stages. Smokers who reported newly
smoke-free homes or workplaces were more likely to quit over the next two years, 
compared with those who did not encounter such restrictions at home or at work.

PMID: 17892249 [PubMed - indexed for MEDLINE]


21. J Occup Environ Med. 2007 Sep;49(9):990-6.

Job strain, life events, and sickness absence: a longitudinal cohort study in a
random population sample.

Suominen S, Vahtera J, Korkeila K, Helenius H, Kivimäki M, Koskenvuo M.

Department of Public Health, University of Turku, Lemminkäisenkatu 1, FIN 20014
University of Turku, Finland. sakari.suominen@utu.fi

OBJECTIVE: To examine job strain, adverse life events, and their co-occurrence as
predictors of sickness absence. METHODS: Random sample-based mail survey data on 
1806 Finns in gainful employment were linked to sickness absence records
(1987-1998) from national health registers. Generalized linear models with
negative binomial distribution assumption were applied. RESULTS: After adjustment
for demographic characteristics and health behavior, job strain (rate ratio [RR] 
1.73; 95% confidence interval [CI] = 1.21-2.48), but not life events,
independently predicted increased rate of sickness absence among men. The
opposite was true for women, (RR for life events 1.39; 95% CI = 1.10-1.75). No
statistically significant interaction between job strain and life events was
detected. CONCLUSION: In addition to job strain, strain originating in private
life should be kept in mind when the need for sickness absence of women employees
is evaluated within health care.

PMID: 17848855 [PubMed - indexed for MEDLINE]


22. Occup Environ Med. 2008 Feb;65(2):120-5. Epub 2007 Aug 6.

Mortality, morbidity and occupational exposure to airway-irritating agents among 
men with a respiratory diagnosis in adolescence.

Wiebert P, Svartengren M, Lindberg M, Hemmingsson T, Lundberg I, Nise G.

Dr P Wiebert, Department of Occupational and Environmental Health, Norrbacka,
Karolinska Hospital, SE-171 76 Stockholm, Sweden; pernilla.wiebert@sll.se.

OBJECTIVES: To examine the influence of an airway diagnosis in adolescence on
future health and occupation in Swedish men. METHODS: Data were collected from
the linkage of four Swedish national registers: the Military Service Conscription
Register, the Population and Housing Censuses, the Inpatient Care Register and
the National Cause of Death Register. A job-exposure matrix for airway-irritating
substances was developed for application on the conscription cohort. The cohort
included 49 321 Swedish men born 1949-51. Three groups-(1) healthy, (2)
asthmatics (mild and severe asthma) and (3) subjects with allergic rhinitis
without concurrent asthma-were identified at conscription and analysed for
mortality, in-patient care and strategies for choice of occupation with emphasis 
on airway-irritating job exposure. Analyses were adjusted for smoking and
childhood socioeconomic position. RESULTS: The prevalence of total asthma was
1.8%, severe asthma 0.45% and allergic rhinitis 2.7%. Mortality for all causes
was significantly higher in total asthma, hazard ratio (HR) 1.49 (95% CI 1.00 to 
2.23), and lower in allergic rhinitis, HR 0.52 (95% CI 0.30 to 0.91). Asthma was 
a risk factor for inpatient care while allergic rhinitis was associated with less
in-patient care (odds ratio (OR) for total asthma 1.16 (95% CI 1.00 to 1.34),
severe asthma 1.38 (95% CI 1.04 to 1.85), allergic rhinitis 0.92 (95% CI 0.82 to 
1.03)). Those with asthma tended to avoid jobs with a high probability for
airway-irritating exposure (OR 0.88, 95% CI 0.71 to 1.09), but not to the same
extent as subjects with allergic rhinitis (OR 0.58, 95% CI 0.47 to 0.70) (ORs
from 1990). CONCLUSION: Subjects with asthma did not change their exposure
situation to the same extent as subjects with allergic rhinitis. Further,
asthmatics had an increased risk for morbidity and mortality compared to healthy 
subjects and subjects with allergic rhinitis.

PMID: 17681997 [PubMed - indexed for MEDLINE]


23. Matern Child Health J. 2008 May;12(3):402-14. Epub 2007 Jul 18.

Understanding breastfeeding initiation and continuation in rural communities: a
combined qualitative/quantitative approach.

Flower KB, Willoughby M, Cadigan RJ, Perrin EM, Randolph G; Family Life Project
Investigative Team.

Charles Drew Community Health Center, Piedmont Health Services, 221 North
Graham-Hopedale Road, Burlington, NC, USA. kflower@nc.rr.com

OBJECTIVE: To determine factors associated with breastfeeding in rural
communities. METHODS: We combined qualitative and quantitative data from the
Family Life Project, consisting of: (1) a longitudinal cohort study (N=1292) of
infants born September 2003-2004 and (2) a parallel ethnographic study (N=30
families). Demographic characteristics, maternal and infant health factors, and
health services were used to predict breastfeeding initiation and discontinuation
using logistic and Cox regression models, respectively. Ethnographic interviews
identified additional reasons for not initiating or continuing breastfeeding.
RESULTS: Fifty-five percent of women initiated breastfeeding and 18% continued
for at least 6 months. Maternal employment at 2 months and receiving WIC were
associated with decreased breastfeeding initiation and continuation. Ethnographic
data suggested that many women had never even considered breastfeeding and often 
discontinued breastfeeding due to discomfort, embarrassment, and lack of
assistance. CONCLUSIONS: Breastfeeding rates in these rural communities lag
behind national averages. Opportunities for increasing breastfeeding in rural
communities include enhancing workplace support, maximizing the role of WIC,
increasing hospital breastfeeding assistance, and creating a social environment
in which breastfeeding is normative.

PMCID: PMC2692345
PMID: 17636458 [PubMed - indexed for MEDLINE]


24. Dev Psychol. 2007 Jul;43(4):877-88.

Life transitions and mental health in a national cohort of young Australian
women.

Lee C, Gramotnev H.

School of Psychology, University of Queensland, St. Lucia, QLD, Australia.
c.lee@psy.uq.edu.au

Young adulthood, a time of major life transitions and risk of poor mental health,
may affect emotional well-being throughout adult life. This article uses
longitudinal survey data to examine young Australian women's transitions across 4
domains: residential independence, relationships, work and study, and motherhood.
Changes over 3 years in health-related quality of life, optimism, depressive
symptoms, stress, and life satisfaction, were examined in relation to these
transitions among 7,619 young adult participants in the nationally representative
Australian Longitudinal Study on Women's Health. Positive changes in mental
health occurred for women moving into cohabitation and marriage, whereas
reductions were observed among those experiencing marital separation or divorce
and those taking on or remaining in traditionally "feminine" roles (out of the
workforce, motherhood). The data suggest that women cope well with major life
changes at this life stage, but reductions in psychological well-being are
associated with some transitions. The findings suggest that preventive
interventions to improve women's resilience and coping might target women
undergoing these transitions and that social structures may not be providing
sufficient support for women making traditional life choices. Copyright 2007 APA.

PMID: 17605521 [PubMed - indexed for MEDLINE]


25. Work. 2007;28(3):225-30.

Who is at risk for long-term sickness absence? A prospective cohort study of
Danish employees.

Lund T, Labriola M, Villadsen E.

National Institute of Occupational Health, Copenhagen, Denmark.

AIM: The aim of this study was to identify who is at risk for long-term sickness 
absence according to occupation, gender, education, age, business sector, agency 
size and ownership. METHODS: The study is based on a sample of 5357 employees
aged 18-69, interviewed in 2000. The cohort was followed up in a national
register from January 1st 2001 to June 30th 2003, to identify cases with sickness
absences that exceeded 8 weeks. RESULTS: During follow-up 486 persons (9.1%)
experienced one or more periods of absence that exceeded 8 weeks. Higher risk of 
long-term sickness absence was associated with gender, age, educational level,
and the municipal employment sector. Kindergarten teachers and people employed in
day care, health care, janitorial work, food preparation, and unskilled workers
were at greatest risk. Managers, computer professionals, technicians and
designers, and professionals had lower risks. The health care and social service 
sectors were also in the high risk category, whereas the private administration
sector had a lower risk. CONCLUSIONS: The study identifies specific occupational 
target populations and documents the need to perform job-specific research and
tailor interventions if the intended policy of decreasing long-term sickness
absence within the Danish labour market is to be realized.

PMID: 17429148 [PubMed - indexed for MEDLINE]


26. Addiction. 2007 Mar;102(3):447-54.

The impact of post-traumatic stress disorder on treatment outcomes for heroin
dependence.

Mills KL, Teesson M, Ross J, Darke S.

National Drug and Alcohol Research Centre, University of New South Wales, NSW,
Australia. k.mills@unsw.edu.au

AIMS: To examine the impact of post-traumatic stress disorder (PTSD) on 2-year
treatment outcomes for heroin dependence. DESIGN: Prospective longitudinal study.
PARTICIPANTS: Data were obtained from a predominantly treatment seeking sample of
615 dependent heroin users who were followed-up at 3, 12 and 24 months (follow-up
rates: 89%, 81% and 76%, respectively). MEASUREMENTS: Outcomes examined include
treatment retention and exposure, substance use, general physical and mental
health and employment. FINDINGS: Despite improvements in substance use, PTSD was 
associated with continued physical (beta - 1.69, SE 0.61, P < 0.01) and mental
disability (beta - 2.07, SE 0.66, P < 0.01), and reduced occupational functioning
(OR 0.67, 95% CI: 0.48-0.93) throughout the 2-year follow-up. CONCLUSIONS:
Although conventional treatment services are successful in producing improvements
in substance use and associated disability, the disability associated with PTSD
remains. An intervention targeting both heroin dependence and PTSD may help to
improve the outcomes of those with PTSD.

PMID: 17298653 [PubMed - indexed for MEDLINE]


27. Am J Ind Med. 2007 Feb;50(2):143-9.

Work-family conflict and mental disorders in the United States: cross-sectional
findings from The National Comorbidity Survey.

Wang J, Afifi TO, Cox B, Sareen J.

Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary,
Canada. jlwang@ucalgary.ca

BACKGROUND: Work-family conflict (WFC) may have negative effects on workers'
health and productivity. The objective of this analysis was to assess the
association between WFC and mental disorders that occurred in the past month.
METHODS: Data from the U.S. National Comorbidity Survey were used. The 1-month
prevalence of mental disorders was estimated by levels of WFC and by gender.
RESULTS: Compared to participants who reported low WFC, those who reported high
WFC had a significantly higher prevalence of mental and/or substance use related 
disorders in the past month. Working hours and domestic roles did not have
significant impacts on the association between WFC and mental disorders,
irrespective of gender. CONCLUSIONS: Work and family roles and the balance
between the two are important for workers' mental health. The influence of WFC on
mental health should be investigated in conjunction with important work
environment characteristics in longitudinal studies.

PMID: 17238143 [PubMed - indexed for MEDLINE]


28. J Subst Abuse Treat. 2007 Jan;32(1):89-96. Epub 2006 Sep 7.

Treatment response by primary drug of abuse: does methamphetamine make a
difference?

Luchansky B, Krupski A, Stark K.

Looking Glass Analytics, Olympia, WA 98501, USA. bill.luchansky@lgan.com

The purposes of this study were to examine the outcomes of a sample of patients
receiving publicly funded substance abuse treatment in Washington State and to
compare the outcomes of those using methamphetamine (MA) with patients using
other drugs of abuse. All data for this study came from administrative systems in
Washington State, and the outcomes included completion of and readmission to
treatment, employment, and various forms of criminal justice involvement.
Treatment records were linked to outcome data using both deterministic and
probabilistic matching techniques. Patients were tracked for 1 year following
their discharge, and analyses were performed separately on a study population of 
adults and a study population of youth. For both adults and youth, the results
showed that across outcomes, there were few differences between MA users and
users of other hard drugs, whereas there were consistent differences between MA
users and users of alcohol and marijuana. Alcohol and marijuana users tended to
have more positive outcomes than the other groups. Future research should focus
on more detailed analyses of the type of treatment received by patients,
particularly for MA users.

PMID: 17175402 [PubMed - indexed for MEDLINE]


29. Arch Phys Med Rehabil. 2006 Dec;87(12):1611-7.

Functional outcomes and life satisfaction in long-term survivors of pediatric
sarcomas.

Gerber LH, Hoffman K, Chaudhry U, Augustine E, Parks R, Bernad M, Mackall C,
Steinberg S, Mansky P.

Rehabilitation Medicine Department, Clinical Center, National Institutes of
Health, Bethesda, MD, USA. ngerber1@gmu

OBJECTIVES: To describe the inter-relationships among impairments, performance,
and disabilities in survivors of pediatric sarcoma and to identify measurements
that profile survivors at risk for functional loss. DESIGN: Prospective,
cross-sectional. SETTING: Research facility. PARTICIPANTS: Thirty-two
participants in National Cancer Institute clinical trials. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Range of motion (ROM), strength, limb volume, 
grip strength, walk velocity, Assessment of Motor and Process Skills (AMPS);
Human Activity Profile (HAP), Sickness Impact Profile (SIP), standard form of the
Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36); and vocational
attitudes and leisure satisfaction. RESULTS: Twenty of 30 survivors tested had
moderate or severe loss of ROM; 13 of 31 tested had 90% or less of predicted walk
velocity; all of whom had trunk or lower-extremity lesions. Women with decreased 
ROM (r=.50, P=.06) or strength (r=.74, P=.002) had slow gait velocity. Sixteen of
31 tested were more than 1 standard deviation below normal grip strength.
Eighteen had increased limb volume. These 18 had low physical competence (SF-36) 
(r=-.70, P=.001) and high SIP scores (r=.73, P=.005). AMPS scores were lower than
those of the matched normed sample (P<.001). HAP identified 15 of 30 who had
moderately or severely reduced activity. Leisure satisfaction was higher in the
subjects (P<.001). Eight reported cancer had negatively impacted work and 17
reported that it negatively impacted vocational plans. CONCLUSIONS: Survivors
with lower-extremity or truncal lesions and women with decreased ROM and strength
likely have slow walk velocity, low exercise tolerance, and high risk for
functional loss. They should be identified using ROM, strength, limb volume, and 
walk time measures.

PMID: 17141641 [PubMed - indexed for MEDLINE]


30. Health Rep. 2006 Oct;17(4):11-29.

Stress and depression in the employed population.

Shields M.

Health Statistics Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
Margot.Shields@statcan.ca

OBJECTIVES: This article describes stress levels among the employed population
aged 18 to 75 and examines associations between stress and depression. DATA
SOURCES: Data are from the 2002 Canadian Community Health Survey: Mental Health
and Well-being and the longitudinal component of the 1994/95 through 2002/03
National Population Health Survey. ANALYTICAL TECHNIQUES: Stress levels were
calculated by sex, age and employment characteristics. Multivariate analyses were
used to examine associations between stress and depression in 2002, and between
stress and incident depression over a two-year period, while controlling for age,
employment characteristics, and factors originating outside the workplace. MAIN
RESULTS: In 2002, women reported higher levels of job strain and general
day-to-day stress. When the various sources of stress were considered
simultaneously, along with other possible confounders, for both sexes, high
levels of general day-to-day stress and low levels of co-worker support were
associated with higher odds of depression, as was high job strain for men. Over a
two-year period, men with high strain jobs and women with high personal stress
and low co-worker support had elevated odds of incident depression.

PMID: 17111591 [PubMed - indexed for MEDLINE]


31. Suicide Life Threat Behav. 2006 Aug;36(4):377-85.

Sooner versus later: factors associated with temporal sequencing of suicide.

Kaplan MS, McFarland BH, Huguet N, Newsom JT.

School of Community Health, Portland State University, P.O. Box 751, Portland, OR
97207, USA. kaplanm@pdx.edu

There are few (if any) population-based prospective studies that provide
information on factors associated with temporal sequencing of suicide. In this
prospective population-based study, the National Health Interview Survey (NHIS), 
1986-1994, was linked to the National Death Index (NDI), 1986-1997, to assess
factors that predict recent (within 12 months of interview, termed sooner)
suicide versus suicide further in the future (more than 12 months after
interview, termed later). Of the 653 completed suicides in the NHIS cohort, 13.4 
percent completed suicide within a year of interview, and 86.6 percent did so
after a year. Sooner decedents were more likely to be White, less educated,
unemployed, and to use firearms than any other method compared with later
decedents. Surprisingly, sooner decedents had higher levels of self-rated health 
at baseline. These results have substantial implications for clinicians and other
professionals who interact with people at highest risk of suicide. Unfortunately,
it may be unrealistic to expect that health care providers can modify the
behavior of individuals at highest risk of suicide.

PMID: 16978092 [PubMed - indexed for MEDLINE]


32. Soc Psychiatry Psychiatr Epidemiol. 2006 Nov;41(11):875-80. Epub 2006 Sep 1.

Depressive symptoms and the risk of long-term sickness absence: a prospective
study among 4747 employees in Denmark.

Bültmann U, Rugulies R, Lund T, Christensen KB, Labriola M, Burr H.

National Institute of Occupational Health, Lersø Parkallé 105, 2100, Copenhagen, 
Denmark. utb@ami.dk

BACKGROUND: The aim of this paper is to examine the impact of depressive symptoms
on long-term sickness absence in a representative sample of the Danish workforce.
METHODS: This prospective study is based on 4,747 male and female employees,
participating in the Danish Work Environment Cohort Study. Depressive symptoms
were measured at baseline. Data on sickness absence were obtained from a national
register on social transfer payments. Onset of long-term sickness absence was
followed up for 78 weeks. RESULTS: The cumulative 78 weeks incidence for the
onset of long-term sickness absence was 6.5% in men and 8.9% in women. Both men
and women with severe depressive symptoms ( or = 10 mm compared to baseline TST. RESULTS: The initial 
TST positivity rate was 63.1%; the follow-up TST conversion rate was 10.7 per
1000 person-months (p-m). Hospital of employment, recent bacille Calmette-Guerin 
(BCG) vaccination, nosocomial TB exposure, and employment as a nurse were
independent risk factors for TST conversion. Hospitals without TB infection
control measures had higher conversion rates than those with control measures
(16.0 vs. 7.8/ 1000 p-m, P < 0.001). CONCLUSIONS: This study indicates an
important occupational risk of infection in health care settings with a high TB
incidence. Longitudinal TST studies are a valuable tool to assess the
occupational risk of TB, even in BCG-vaccinated populations, and should be used
to direct limited resources for infection control.

PMID: 16466055 [PubMed - indexed for MEDLINE]


41. J Adv Nurs. 2006 Feb;53(4):392-402.

Stress and well-being among parents of children with rare diseases: a prospective
intervention study.

Dellve L, Samuelsson L, Tallborn A, Fasth A, Hallberg LR.

Assistant Professor, Department of Public Health and Community Medicine,
Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.

AIM: This paper reports a study to assess stress, well-being and supportive
resources experienced by mothers and fathers of children with rare disabilities, 
and how these variables were affected by an intensive family competence
intervention. BACKGROUND: Despite diagnosis-specific studies, little overall
knowledge exists about life-consequences for families of children with rare
disorders. METHOD: We used a prospective design with baseline data and two
follow-ups (at 6 and 12 months) after an intervention. The intervention aimed at 
empowering parents in managing their child's disability. Parents from all parts
of Sweden visiting a national centre for families of children with rare
disabilities were consecutively selected (n = 136 mothers, 108 fathers).
Instruments of parental stress, social support, self-rated health, optimism and
life satisfaction and perceived physical or psychological strain were used.
Stratified analyses were carried out for mothers and fathers, and related to
parental demands: single mothers, full-time employment, participation in a parent
association, child's age and type of disability. RESULTS: We found high parental 
stress, physical and emotional strain among mothers, especially among single
mothers. Fathers showed high stress related to incompetence, which decreased
after the intervention. Decreased strain was found among full-time working
mothers and fathers after the intervention. Parents' perceived knowledge and
active coping and mothers' perceived social support were increased at follow-up. 
Factors related to parents' overall life satisfaction (57-70% explained variance)
changed after the intervention, from being more related to internal demands
(perceived strain, incompetence and social isolation) to other conditions, such
as problems related to spouse, paid work and social network. CONCLUSION: Parents,
especially fathers and full-time working parents, may benefit from an intensive
family competence programme.

PMID: 16448482 [PubMed - indexed for MEDLINE]


42. J Health Care Poor Underserved. 2005 Nov;16(4):655-76.

The effect of socioeconomic status on the survival of people receiving care for
HIV infection in the United States.

Cunningham WE, Hays RD, Duan N, Andersen R, Nakazono TT, Bozzette SA, Shapiro MF.

Division of General Internal Medicine and Health Services Research, Department of
Medicine, Center for Health Sciences, School of Public Health, UCLA, Los Angeles,
CA 90095, USA. wcunningham@mednet.ucla.edu

HIV-infected people with low socioeconomic status (SES) and people who are
members of a racial or ethnic minority have been found to receive fewer services,
including treatment with Highly Active Antiretroviral Therapy (HAART), than
others. We examined whether these groups also have worse survival than others and
the degree to which service use and antiretroviral medications explain these
disparities in a prospective cohort study of a national probability sample of
2,864 adults receiving HIV care. The independent variables were wealth (net
accumulated financial assets), annual income, educational attainment, employment 
status (currently working or not working), race/ethnicity, insurance status, use 
of services, and use of medications at baseline. The main outcome variable was
death between January 1996 and December 2000. The analysis was descriptive and
multivariate adjusted Cox proportional hazards regression analysis of survival.
By December 2000, 20% (13% from HIV, 7% non-HIV causes) of the sample had died.
Those with no accumulated financial assets had an 89% greater risk of death
(RR=1.89, 95% CI=1.15-3.13) and those with less than a high school education had 
a 53% greater risk of death (RR=1.53, 95% CI=1.15-2.04 ) than their counterparts,
after adjusting for sociodemographic and clinical variables only. Further
adjusting for use of services and antiretroviral treatment diminished, but did
not eliminate, the elevated relative risk of death for those with low SES by
three of the four measures. The finding of markedly elevated relative risks of
death for those with HIV infection and low SES is of particular concern given the
disproportionate rates of HIV infection in these groups. Effective interventions 
are needed to improve outcomes for low SES groups with HIV infection.

PMID: 16311491 [PubMed - indexed for MEDLINE]


43. Scand J Work Environ Health. 2005 Oct;31(5):329-35.

Long workhours, work scheduling and work-related injuries among construction
workers in the United States.

Dong X.

The Center to Protect Workers' Rights, Silver Spring, MD 20910, USA.
SDong@cpwr.com

OBJECTIVES: The objectives of this study were (i) to examine work scheduling in
construction and (ii) to establish whether there is any connection between
workhours and safety outcomes among construction workers. METHODS: The National
Longitudinal Survey of Youth, 1979 cohort (NLSY79), was used for the data
analysis. Odds ratios were used to measure the risk of work-related injury in
different worker groups. RESULTS: The findings showed that (i) construction
workers started work earlier, worked longer days and fewer weeks a year, and were
more likely to hold multiple jobs and change jobs than their nonconstruction
counterparts and (ii) long workhours and irregular work schedules were
significantly associated with a higher work-related injury rate after control for
possible confounders. CONCLUSION: The results provide evidence that overtime and 
irregular work scheduling have an adverse effect on worker safety.

PMID: 16273958 [PubMed - indexed for MEDLINE]


44. J Sch Health. 2005 Nov;75(9):350-8.

Risk behaviors for varying categories of disability in NELS:88.

Hollar D.

Department of Medical Genetics, University of Tennessee Graduate School of
Medicine, Knoxville 37920, USA. dhollar@mc.utmck.edu

A large body of research shows that youth with disabilities, who comprise about
13% of the country's school-aged population, report comparable to higher
incidence rates of alcohol, tobacco, and other drug (ATOD) use than their peers. 
Furthermore, youth with disabilities who reported ATOD use or who engaged in
binge drinking had significantly more negative educational outcomes and engaged
in sexual activity at a younger age than nonusers. This study describes risk
factors for substance use, personal characteristics, aspects of the attitudinal
environment, and educational, employment, and social outcomes among youth across 
6 categories of disability. Data came from the National Center for Education
Statistics' National Education Longitudinal Study of 1988-2000 (NELS:88). The
findings indicate that (a) youth with varying types of disabilities are
relatively homogenous with respect to risk behaviors, personal characteristics,
and outcomes; (b) youth with emotional, learning, or multiple disabilities may be
at heightened risk for binge drinking and marijuana use; and (c) youth with
emotional and multiple disabilities may be less likely to graduate from high
school or its equivalent 8 years beyond the 12th grade. Based on these results
and limitations of the NELS sampling strategy, appropriate interventions are
discussed as well as the need for more definitive operational definitions for
disabilities, specifically the biopsychosocial approach used by the International
Classification of Functioning, Disability, and Health.

PMID: 16255721 [PubMed - indexed for MEDLINE]


45. Int J Audiol. 2005 Sep;44(9):531-9.

Smoking and height as risk factors for prevalence and 5-year incidence of hearing
loss. A questionnaire-based follow-up study of employees in Denmark aged 18-59
years exposed and unexposed to noise.

Burr H, Lund SP, Sperling BB, Kristensen TS, Poulsen OM.

National Institute of Occupational Health, Copenhagen, Denmark. hb@ami.dk

This paper investigated whether smoking and short stature in adulthood were
independent risk factors for hearing loss. We reanalyzed data from the Danish
Work Environment Cohort Study (an existing cohort study), on prevalence of
self-reported hearing loss among 7,221 employees and on five-year incidence among
4,610 employees. We found that smoking predicted hearing loss incidence and
prevalence. Smoking did not predict incidence at noise exposure during half or
more of a worker's hours. Very short stature predicted prevalence in the total
adult population only weakly, but strongly among employees born before 1951.
These prospective findings indicate that smoking is an independent risk factor
for incidence of hearing loss. Very short stature predicted prevalence of hearing
loss only in a subpopulation.

PMID: 16238184 [PubMed - indexed for MEDLINE]


46. Occup Environ Med. 2005 Nov;62(11):800-5.

A prospective cohort study among new Chinese coal miners: the early pattern of
lung function change.

Wang ML, Wu ZE, Du QG, Petsonk EL, Peng KL, Li YD, Li SK, Han GH, Atffield MD.

National Institute for Occupational Safety and Health, Division of Respiratory
Disease Studies, Morgantown, WV 26505, USA. mlw4@cdc.gov

AIMS: To investigate the early pattern of longitudinal change in forced
expiratory volume in 1 second (FEV1) among new Chinese coal miners, and the
relation between coal mine dust exposure and the decline of lung function.
METHODS: The early pattern of lung function changes in 317 newly hired Chinese
underground coal miners was compared to 132 referents. This three year
prospective cohort study involved a pre-employment and 15 follow up health
surveys, including a questionnaire and spirometry tests. Twice a month, total and
respirable dust area sampling was done. The authors used a two stage analysis and
a linear mixed effects model approach to analyse the longitudinal spirometry
data, and to investigate the changes in FEV1 over time, controlling for age,
height, pack years of smoking, mean respirable dust concentration, the room
temperature during testing, and the groupxtime interaction terms. RESULTS: FEV1
change over time in new miners is non-linear. New miners experience initial rapid
FEV1 declines, primarily during the first year of mining, little change during
the second year, and partial recovery during the third year. Both linear and
quadratic time trends in FEV1 change are highly significant. Smoking miners lost 
more FEV1 than non-smokers. Referents, all age less than 20 years, showed
continued lung growth, whereas the miners who were under age 20 exhibited a
decline in FEV1. CONCLUSION: Dust and smoking affect lung function in young,
newly hired Chinese coal miners. FEV1 change over the first three years of
employment is non-linear. The findings have implications for both methods and
interpretation of medical screening in coal mining and other dusty work: during
the first several years of employment more frequent testing may be desirable, and
caution is required in interpreting early FEV1 declines.

PMCID: PMC1740897
PMID: 16234407 [PubMed - indexed for MEDLINE]


47. Food Nutr Bull. 2005 Jun;26(2 Suppl 1):S25-45.

Social and economic development and change in four Guatemalan villages:
demographics, schooling, occupation, and assets.

Maluccio JA, Melgar P, Méndez H, Murphy A, Yount KM.

Department of Global Health, Rollins School of Public Health, Emory University,
Atlanta, GA 20006, USA. J.Maluccio@cgiar.org

This article uses census data and village histories to examine changes over the
last 35 years in the four villages where the Institute of Nutrition of Central
America and Panama (INCAP) Longitudinal Study (1969-77) was conducted and offers 
a rare picture of development and change in rural localities over a long period
of time. In addition, by characterizing the environment in which the subjects of 
this study were raised, we provide context for and inputs into quantitative
analyses of data collected at various points in time on these subjects. The
villages have undergone massive demographic, social, and economic change. Initial
differences have conditioned many of these changes, especially differences
associated with agricultural potential and location. Originally these villages
were rather isolated, but road and transportation access has improved
substantially. The populations in the villages have more than doubled and also
have aged. While marriage patterns have held steady, religious practice has
changed a great deal. After many years of steady out-migration, three of the four
villages are more recently experiencing net in-migration, a pattern associated
with ease of access. Schooling access and outcomes also have improved, with
average grades of schooling nearly tripling and literacy doubling to levels
currently above national averages. Although agriculture remains an important
component of individual livelihood strategies, non-agricultural sources of
employment have become more important. Much of this change is associated with
declining agricultural markets and increased access to non-agricultural jobs near
the villages and in the capital. Accompanying these changes has been an
improvement in living standards as measured by a number of indicators of
household living conditions and consumer durable goods.

PMID: 16060210 [PubMed - indexed for MEDLINE]


48. Eur J Public Health. 2005 Oct;15(5):511-7. Epub 2005 Jul 21.

Mortality among 723,948 foreign- and native-born Swedes 1970-1999.

Albin B, Hjelm K, Ekberg J, Elmståhl S.

School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
bjorn.albin@ivosa.vxu.se

BACKGROUND: Mortality in a population is regarded as an accurate and valid
measure of the population's health. There are a few international studies,
predominantly cross-sectional, of mortality among all foreign-born compared with 
an indigenous population, and the results have varied. No Swedish longitudinal
study describing and analysing mortality data was found in a literature review.
METHODS: This study describes and analyses the differences in mortality between
foreign-born persons and native Swedes during the period 1970-1999, based on data
from Statistics Sweden and the National Board of Health and Welfare. The database
consisted of 723,948 persons, 361 974 foreign-born living in Sweden in 1970, aged
> or = 16 years, and 361 974 Swedish controls matched for age, sex, occupation
and type of employment, living in the same county in 1970. RESULTS: The results
showed increased mortality for foreign-born persons compared with the Swedish
controls [odds ratio (OR) 1.08; 95% confidence interval (CI) 1.07-1.08]. Persons 
who had migrated 'late' (1941-1970) to Sweden were 2.5 years younger at time of
death than controls. In relation to country of birth, the highest risk odds were 
for men born in Finland (OR 1.21), Denmark (OR 1.11) and Norway/Iceland (OR
1.074). Age cohorts of foreign-born persons born between 1901 and 1920 had higher
mortality at age 55-69 years than cohorts born between 1921 and 1944.
CONCLUSIONS: Migrants had higher mortality than the native population, and
migration may be a risk factor for health; therefore, this seems to be an
important factor to consider when studying mortality and health.

PMID: 16037077 [PubMed - indexed for MEDLINE]


49. Soc Sci Med. 2006 Jan;62(2):303-16. Epub 2005 Jul 18.

Racial, ethnic, and gender differences in smoking cessation associated with
employment and joblessness through young adulthood in the US.

Weden MM, Astone NM, Bishai D.

Population Health Sciences, University of Wisconsin-Madison, 1007 WARF Office
Bldg., 53726, USA. wden@wisc.edu

The dynamics of labor force participation and joblessness during young adulthood 
influence access to social and material resources and shape exposure to different
sources of psychosocial strain. Differences in these dynamics by race, ethnicity,
and gender are related to changes in a behavioral determinant of poor health
(tobacco use) for young adults aging into midlife. Using discrete-time hazards
models, we estimate the relationship between labor force participation in the
past year and smoking cessation for US adults (ages 14-21 years in 1979) followed
in a population-representative sample until 1998 (i.e. the National Longitudinal 
Survey of Youth). We assess the unique role of racial, ethnic and gender
differences in exposure, vulnerability, and reactivity to employment and
joblessness by controlling for social and economic resources obtained through
working and by controlling for early life factors that select individuals into
certain labor force and smoking trajectories. There are three main findings: (1) 
joblessness is more strongly associated with persistent daily smoking among women
than among men; (2) fewer social and economic resources for women out of the
labor force compared to employed women explains their lower cessation rates; and 
(3) lower cessation among unemployed women compared to employed women can only
partially be explained by these resources. These findings illustrate how
differential access to work-related social and economic resources is an important
mediator of poor health trajectories. Contextual factors such as social norms and
psychosocial strains at work and at home may play a unique role among European
American men and women in explaining gender differences in smoking.

PMID: 16029919 [PubMed - indexed for MEDLINE]


50. Ann Chir Plast Esthet. 2005 Jun;50(3):202-5. Epub 2004 Dec 10.

[Social adjustment in French adults from who had undergone standardised treatment
of complete unilateral cleft lip and palate]

[Article in French]

Danino A, Gradell J, Malka G, Moutel G, Hervé C, Rosilio C.

Service de chirurgie maxillo faciale et plastique, CHU de Dijon, 3 rue du
Faubourg-Raine, 21000 Dijon, France. alain.danino@chu-dijon.fr

France has a population of about 60 million peoples and each ten years data about
the standard of living are collected by the central bureau of statistics, we
considered the collection of data on 5000 households in 1999 in our geographical 
area would afford a unique opportunity to compare the equivalent status of French
adults with repaired cleft of the lip and palate (CLP). Aspects of social
adjustment were investigated in a sample of 82 French adults 18-35 years old with
repaired complete unilateral cleft of the lip and palate (CLP). All subjects
received a standardized regimen of care from the Burgundy cleft palate team of
Dijon. The investigation, based on response to a questionnaire, partly replicated
a national survey of social and economic life in the population (Standard of
living survey Burgundy, INSEE France 1999), so that adults with complete clefts
could be compared with a large control sample of the same age. The control group 
was constituted by subjects between 18 and 35 years in the standard of living
survey Burgundy 1999, INSEE France, they were taken from a regional probability
sample of households. This report covers education, employment, and marriage. The
significant difference between groups was assessed by: Student's t-test or
analysis of variance for continuous variables and chi2 test for categorical
variables. The results demonstrated that there are significant differences in
educational attainment and employment between adults with cleft of the lip and
palate and other people. Fewer with cleft of the lip and palate marry, and when
they marry they do so later in life, scholarship history showed significant delay
in the cleft of the lip and palate group, independence regarding housing was
lower in the cleft of the lip and palate group. If cleft of the lip and palate
adults functioned within normal limits with regard to employment. However, levels
of income were substantively lower than control groups. It would appear that
cleft subjects experience some limitation in their ability to secure vocational
and economic rewards from society. As a conclusion we can say regarding our
results that the cleft of the lip and palate group, even with the smallest degree
of malformation (unilateral without associated malformation), showed a
significant delay in the independence process.

PMID: 15963840 [PubMed - indexed for MEDLINE]


51. East Afr Med J. 2004 Apr;81(4):207-11.

Profile of suicide in Dar es Salaam.

Ndosi NK, Mbonde MP, Lyamuya E.

Department of Psychiatry, Muhimbili University College of Health Sciences, P.O.
Box 65051, Dar es Saalam, Tanzania.

OBJECTIVE: To investigate individual socio-demographic characteristics of
suicides, the reasons, methods and means employed to commit suicide. DESIGN: A
descriptive prospective study of suicides. A structured questionnaire was
employed to enquire the details of the itemised objectives. SETTING: Muhimbili
National Hospital--in urban Dar es Salaam. SUBJECTS: Fifty three males and 47
females consecutive suicides aged 15 to 59 years RESULTS: The mean age for
suicides was found to be 28.2 years. Males were more than females and were ten
years older. Sixty two percent of the subjects were single, 30% married. Seventy 
two percent had primary school education, 19% secondary education. Main reasons
for committing suicide were established in 61 cases of which 57.3% (35/61) were
due to severe marital and family conflicts, overwhelming disappointments in love 
affairs and unwanted pregnancies. Eleven subjects with chronic somatic illnesses 
killed themselves due to unbearable physical pain and overwhelming economic
deprivations motivated ten subjects to take their lives. Sixty nine subjects
poisoned themselves predominantly using anti-malarials and pesticides while 27
hanged themselves. A third of the suicides consumed alcohol frequently and a
quarter of the suicides were HIV positive, a rate twice the national prevalence
for sexually active adults. CONCLUSION: Comparatively, women became vulnerable to
suicide at a younger age. Dysfunctional social networks played a predominant role
among suicides. Family and marital conflicts need closer social attention and
timely counseling. Patients with chronic medical conditions and frequent alcohol 
use need effective exploration concerning suicidal ideation to avert
self-annihilation. A policy to control prescriptions of toxic drugs including
pesticides is overdue.

PMID: 15884288 [PubMed - indexed for MEDLINE]


52. Child Dev. 2005 Mar-Apr;76(2):467-82.

Mothers' time with infant and time in employment as predictors of mother-child
relationships and children's early development.

Huston AC, Rosenkrantz Aronson S.

Department of Human Ecology, University of Texas at Austin, TX 78712-0141, USA.
achuston@mail.utexas.edu 

This study tested predictions from economic and developmental theories that
maternal time with an infant is important for mother-child relationships and
children's development, using time-use diaries for mothers of 7- to 8-month-old
infants from the National Institute of Child Health and Human Development Study
of Early Child Care (N = 1,053). Employment reduced time with infants, but
mothers compensated for some work time by decreasing time in other activities.
With family and maternal characteristics controlled, time with infants predicted 
high Home Observation for Measurement of the Environment (HOME) scores and
maternal sensitivity, but bore little relation to children's engagement with
mothers, secure attachment, social behavior, or cognitive performance from 15 to 
36 months. Mothers who spent more time at work had higher HOME scores. Maternal
time with infants may reflect maternal characteristics that affect both time
allocation and maternal behavior.

PMID: 15784094 [PubMed - indexed for MEDLINE]


53. Am J Public Health. 2005 Mar;95(3):518-24.

Natural mentoring relationships and adolescent health: evidence from a national
study.

DuBois DL, Silverthorn N.

Community Health Sciences Division, School of Public Health (MC 923), University 
of Illinois at Chicago, 1603 W Taylor St, Chicago, IL 60612-4324, USA.
dldubois@uic.edu

OBJECTIVES: We used nationally representative data to examine the impact of
natural (or informal) mentoring relationships on health-related outcomes among
older adolescents and young adults. METHODS: We examined outcomes from Wave III
of the National Longitudinal Study of Adolescent Health as a function of whether 
or not respondents reported a mentoring relationship. Logistic regression was
used with control for demographic variables, previous level of functioning, and
individual and environmental risk. RESULTS: Respondents who reported a mentoring 
relationship were more likely to exhibit favorable outcomes relating to
education/work (completing high school, college attendance, working >/= 10 hours 
a week), reduced problem behavior (gang membership, hurting others in physical
fights, risk taking), psychological well-being (heightened self-esteem, life
satisfaction), and health (physical activity level, birth control use). However, 
effects of exposure to individual and environmental risk factors generally were
larger in magnitude than protective effects associated with mentoring.
CONCLUSIONS: These findings suggest a broad and multifaceted impact of mentoring 
relationships on adolescent health. However, mentoring relationships alone are
not enough to meet the needs of at-risk youths and therefore should be
incorporated into more comprehensive interventions.

PMCID: PMC1449212
PMID: 15727987 [PubMed - indexed for MEDLINE]


54. Am J Public Health. 2005 Mar;95(3):453-7.

Moderate alcohol use and depression in young adults: findings from a national
longitudinal study.

Paschall MJ, Freisthler B, Lipton RI.

Prevention Research Center, Pacific Institute for Research and Evaluation, 1995
University Ave, Suite 450, Berkeley, CA 94704, USA. paschall@pire.org

OBJECTIVES: We examined the association between moderate alcohol use and
depressive mood among young adults before and after adjustment for demographic,
health, and socioeconomic factors that may act as confounders. METHODS: We
analyzed 2 waves of interview data collected from 13892 young adults who
participated in the National Longitudinal Study of Adolescent Health to compare
frequency of depressive symptoms in moderate drinkers with frequency of symptoms 
in young adults in other alcohol use categories. RESULTS: With adjustment for
health and socioeconomic factors, frequency of depressive symptoms were similar
among moderate drinkers, lifetime and long-term abstainers, and heavy/heavier
moderate drinkers but remained significantly higher among heavy drinkers.
CONCLUSIONS: Moderate alcohol use may have no effect on depression in young
adults relative to abstinence from alcohol use.

PMCID: PMC1449201
PMID: 15727976 [PubMed - indexed for MEDLINE]


55. J Intellect Disabil Res. 2005 Mar;49(Pt 3):171-82.

Social outcomes in adulthood of children with intellectual impairment: evidence
from a birth cohort.

Hall I, Strydom A, Richards M, Hardy R, Bernal J, Wadsworth M.

Department of Psychiatry and Behavioural Sciences, University College London,
London, UK. i.hall@ucl.ac.uk

BACKGROUND: Social Policy for people with intellectual disabilities (ID)
continues to evolve, but little is known about the lives to which such policies
are applied. We aimed to use a prospective follow-up of a British birth cohort to
identify children with mild and more severe intellectual impairment, and compare 
a range of social outcomes in adulthood with people in the rest of the cohort.
METHOD: We used data from the MRC National Survey for Health and Development.
Intellectual impairment was identified by intelligence tests and educational
history. Adult outcome measures included employment and social class, education, 
marriage and children, home ownership, social networks and community use.
RESULTS: We identified 111 people with mild intellectual impairment (2.7%) and 23
with severe intellectual impairment (0.6%) at age 15/16. By the age of 43, there 
were 52 people remaining in the mild impairment group and 14 in the severe
impairment group. In adulthood those with intellectual impairment enjoyed contact
with friends and family, and joined in informal social activities. Although the
mild intellectual impairment group were less likely to attain the following
social outcomes than people with normal intellectual functioning, 67% had jobs,
73% were married, 62% had children and 54% owned their own homes. 12%
participated in adult education. People with more severe intellectual impairment 
were less likely to attain these outcomes. CONCLUSIONS: These outcomes highlight 
issues in current social policy and suggest efforts should be directed
particularly towards promoting educational opportunities and developing social
inclusion for people with ID.

PMID: 15713192 [PubMed - indexed for MEDLINE]


56. J Neurosci Nurs. 2004 Dec;36(6):312-21.

The influence of resources on perceived functional limitations among women with
multiple sclerosis.

Clingerman E, Stuifbergen A, Becker H.

Western Michigan University, Kalamazoo, MI, USA. emclinge@yahoo.com

The purpose of this longitudinal investigation was to identify the effects of
external resources (i.e., education, marriage, employment, social support,
economic status) on the trajectory of perceived functional limitation among women
with multiple sclerosis (MS). We hypothesized that these resources would have a
long-term influence upon MS-related functional limitation. As part of a
longitudinal study of health promotion and quality of life among persons with MS,
we tested hypothesized relationships using data obtained at five time points,
using repeated-measures MANOVA. We found that functional limitation scores
increased over time for all participants. In general, women who were unemployed
as a result of MS consistently had higher functional limitation scores, and
employed women consistently had lower functional limitation scores. Women with
lower social support scores consistently perceived greater functional limitation 
than those with higher social support scores. Women with lower
perceived-economic-adequacy scores consistently had higher functional limitation 
scores than women with higher perceived-economic-adequacy scores. Nurses and
other healthcare professionals are in an optimum position to observe and assess
the resources of women with MS. They can use presence, listening, and
observational skills to identify verbal and nonverbal cues of resource depletion.
In addition, they can act as advocates for women with MS and speak out on policy 
issues and legislation at the local and national levels. Healthcare professionals
can thus influence the presence of resources for those who are particularly
vulnerable to resource loss, so they can participate successfully in work,
recreational, and home environments.

PMID: 15673206 [PubMed - indexed for MEDLINE]


57. Accid Anal Prev. 2005 Mar;37(2):245-51.

Drinking history and risk of fatal injury: comparison among specific injury
causes.

Chen LH, Baker SP, Li G.

Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public
Health, 624 N Broadway, Baltimore, MD 21205-1996, USA. lhchen@jhsph.edu

The effect of acute alcohol use on injury risk is well documented, but the
relationship between drinking history and fatal injury has not been adequately
studied. The authors performed a case-control analysis to explore the association
between drinking history and specific causes of fatal injury. Cases (n=5549) were
persons who died from injury, selected from the 1993 National Mortality
Followback Survey (NMFS); controls (n=42,698) were a representative sample of the
general population, selected from the 1992 National Longitudinal Alcohol
Epidemiologic Survey (NLAES). Current drinkers comprised 59% of the cases
compared with 44% of the controls. After adjustment for age, sex, race/ethnicity,
education, marital status, employment, and drug use, the odds ratio (OR) of dying
from drowning for current drinkers was 3.48 (95% confidence interval (CI)=1.94,
6.25), the highest among all causes of injury studied. The lowest adjusted odds
ratio associated with current drinking was for falls (OR=1.38; 95% CI=1.05,
1.82). Being a current drinker increased the risk of dying from suicide more for 
females (OR=4.04; 95% CI=1.64, 9.93) than for males (OR=1.45; 95% CI=1.20, 1.74).
The authors conclude that drinking history is associated with a significantly
increased risk of all types of fatal injury.

PMID: 15667810 [PubMed - indexed for MEDLINE]


58. Alcohol Clin Exp Res. 2005 Jan;29(1):98-106.

Drinking, alcohol problems and the five-year recurrence and incidence of male to 
female and female to male partner violence.

Caetano R, McGrath C, Ramisetty-Mikler S, Field CA.

University of Texas School of Public Health, Dallas Regional Campus, Dallas,
Texas, USA. Raul.Caetano@UTSouthwestern.edu

BACKGROUND: This study examined the 5-year incidence and recurrence of male to
female (MFPV) and female to male partner violence (FMPV) as well as their
relationship with drinking and alcohol problems among intact couples in the
United States. METHODS: A national sample of couples 18 years of age or older
were interviewed in 1995 and again in 2000. RESULTS: Recurrence is slightly
higher for FMPV (44%) than MFPV (39%), whereas incidence rates are similar for
these two types of violence (MFPV, 5.7%; FMPV, 6%). Cross-tabulations show that a
higher frequency of drinking five or more drinks on occasion is positively
associated with the overall occurrence of MFPV and with both the recurrence and
the overall occurrence of FMPV. Male alcohol problems are associated with a
higher recurrence of MFPV and higher overall MFPV. Female alcohol problems are
associated with incidence of FMPV. In multivariate analysis, black ethnicity,
male unemployment, and severe physical abuse during childhood are associated with
recurrence of MFPV. Black ethnicity, male unemployment, male employment status as
"retired/other," female age, and couples in which the female drinks more are
associated with recurrence of FMPV. Incidence of MFPV is associated with
cohabitation, Hispanic ethnicity, and man's observation of violence between
parents. Male unemployment, male observation of violence between parents, and
man's drinking volume predict incidence of FMPV. CONCLUSIONS: Volume of drinking 
is the only alcohol indicator associated with intimate partner violence once the 
effects of other factors are controlled in multivariate analysis. Both MFPV and
FMPV are areas of health disparity across whites, blacks, and Hispanics. Factors 
of risk that predict recurrence and incidence can be identified and used in
prevention efforts.

PMID: 15654298 [PubMed - indexed for MEDLINE]


59. Am J Orthopsychiatry. 2004 Oct;74(4):577-83.

Transracial, same-race adoptions, and the need for multiple measures of
adolescent adjustment.

Burrow AL, Finley GE.

Department of Psychology, Florida International University, Miami, FL 33199, USA.
anthony.burrow@fiu.edu.

Using a multimeasure approach, the current study investigated 12 indices of
academic, familial, psychological, and health outcomes for 4 groups of
transracial and same-race adopted adolescents. A secondary analysis of the
National Longitudinal Study of Adolescent Health data showed that Asian
adolescents adopted by White parents had both the highest grades and the highest 
levels of psychosomatic symptoms, whereas Black adolescents adopted by Black
parents reported the highest levels of depression. Intriguingly, and by contrast,
Black adoptees reported higher levels of self-worth than non-Black adoptees. The 
implications of the findings for future investigations of transracial adoption
are discussed. ((c) 2004 APA, all rights reserved).

PMID: 15554817 [PubMed - indexed for MEDLINE]


60. Soc Sci Med. 2005 Jan;60(1):49-60.

Women's status and depressive symptoms: a multilevel analysis.

Chen YY, Subramanian SV, Acevedo-Garcia D, Kawachi I.

Department of Society, Human Development and Health, Harvard School of Public
Health, Landmark Center 401 Park Drive, Room 445-A Boston, MA 02115, USA.
ychen@hsph.harvard.edu

The effects of state-level women's status and autonomy on individual-level
women's depressive symptoms were examined. We conducted a multi-level analysis of
the 1991 longitudinal follow up of the 1988 National Maternal Infant Health
Survey (NMIHS), with 7789 women nested within the fifty American states.
State-level women's status was assessed by four composite indices measuring
women's political participation, economic autonomy, employment & earnings, and
reproductive rights. The main outcome measure was symptoms of depression (Center 
for Epidemiologic Studies Depression Scale, CES-D). The participants were a
nationally representative stratified random sample of women in the USA aged
between 17 and 40 years old who gave birth to live babies in 1988, were
successfully contacted again in 1991 and provided complete information on
depressive symptoms. Women who were younger, non-white, not currently married,
less educated or had lower household income tended to report higher levels of
depressive symptoms. Compared with states ranking low on the employment &
earnings index, women residing in states that were high on the same index scored 
0.85 points lower on the CES-D (p<0.01). Women who lived in states that were high
on the economic autonomy index scored 0.83 points lower in depressive symptoms
(p<0.01), compared with women who lived in states low on the same index. Finally,
women who resided in states with high reproductive rights scored 0.62 points
lower on the CES-D (p<0.05) compared with women who lived in states with lower
reproductive rights. Gender inequality appears to contribute to depressive
symptoms in women.

PMID: 15482866 [PubMed - indexed for MEDLINE]


61. J Health Soc Behav. 2004 Jun;45(2):187-97.

Further evidence on adolescent employment and substance use: differences by race 
and ethnicity.

Johnson MK.

Department of Sociology, Washington State University, Pullman, Washington
99164-4020, USA. monicakj@wsu.edu

In an on-going debate over the consequences of adolescent employment, there is
growing agreement that work intensity (i.e., longer hours) fosters underage
drinking and other substance use. The current study furthers our understanding of
the relationship between hours of employment and substance use in adolescence by 
testing whether it is evident across racial/ethnic groups. Based on data from two
waves of the National Longitudinal Study of Adolescent Health, the study finds
that the effects of work intensity on substance use is mostly limited to whites. 
Work intensity is not consistently related to alcohol, cigarette, and marijuana
use among minority adolescents.

PMID: 15305759 [PubMed - indexed for MEDLINE]


62. Fam Pract. 2004 Aug;21(4):355-63.

Adjusting for case mix and social class in examining variation in home visits
between practices.

Sullivan CO, Omar RZ, Forrest CB, Majeed A.

Public Health Policy Unit, School of Public Policy, University College London,
UK. caoimhe.osullivan@uclh.nhs.uk

OBJECTIVES: The purpose of this study was to investigate whether adjusting for
clinical case mix and social class explains more of the variation in home visits 
between general practices than adjusting for age and sex alone. METHODS: The
setting was 60 general practices in England and Wales taking part in the 1 year
Fourth National Morbidity Survey. The participants comprised 349 505 patients who
were registered with one of the participating general practices for at least 180 
days, and who had at least one consultation during the period. The outcome
measure is whether or not a patient received a home visit in that year. A
clinical case mix category (morbidity class) based on 1 year's diagnostic
information was assigned to each patient using the Johns Hopkins Adjusted
Clinical Groups (ACG) Case Mix System. The social class measure was derived from 
occupation and employment status and is similar to that of the 1991 UK census.
Variations in home visits between practices were examined using multilevel
logistic regression models. The variability between practices before and after
adjusting for clinical case mix and social class was estimated using the
intracluster correlation coefficient (ICC). RESULTS: The overall percentage of
patients receiving a home visit over the 1 year study period was 17%, and this
varied from 7 to 31% across the 60 practices. The percentage of the total
variation in home visits attributable to differences between practices was 2.5%
[95% confidence interval (CI) 1.4-3.2%] after adjusting for age and sex. This
reduced to 1.6% (95% CI 1.1-2.4%) after taking into account morbidity class. The 
results were similar when social class was included instead of morbidity class.
Morbidity and social class together reduced variation in home visits between
practices to 1.5% (95% CI 1.1-2.2%). CONCLUSIONS: Age, sex, social class and
clinical case mix are strong determinants of home visits in the UK. Adjusting for
morbidity and social class results in a small improvement in explaining the
variability in home visits between practices compared with adjusting for age and 
sex alone. There is far more variation between patients within practices;
however, it is not straightforward to examine the factors influencing this
variation. In addition to morbidity and social class, there could also be other
unmeasured factors such as varying patient demand for home visits, disability or 
differences in GP home visiting practice style that could influence the large
within-practice variability observed in this study.

PMID: 15249522 [PubMed - indexed for MEDLINE]


63. Subst Use Misuse. 2004 May;39(6):931-62.

Relationship of substance use by students with disabilities to long-term
educational, employment, and social outcomes.

Hollar D, Moore D.

Department of Medical Genetics, The University of Tennessee Graduate School of
Medicine, Knoxville, Tennessee 37920, USA. dhollar@mc.utmck.edu

The study is based on data from the National Education Longitudinal Study of
1988-2000 (NELS: 88). The results indicate that adolescents with disabilities who
used either cigarettes or marijuana or who engaged in binge drinking had
significantly higher dropout rates, lower high school graduation status, lower
college attendance, and lower high school grade point averages, and fewer earned 
core credit units in English, science, and mathematics than nonusers. In
addition, adolescents with disabilities who used either cigarettes, alcohol, or
drugs were significantly more likely to engage in sexual activity at a younger
age. The findings support the need for improved substance use prevention
programming targeting the needs of youth with disabilities.

PMID: 15217199 [PubMed - indexed for MEDLINE]


64. Scand J Public Health. 2004;32(3):164-71.

Work environment and smoking cessation over a five-year period.

Albertsen K, Hannerz H, Borg V, Burr H.

Department of Psychology and Sociology, National Institute of Occupational
Health, Copenhagen, Denmark. ka@ami.dk

AIMS: The authors set out to estimate effects of occupational factors on smoking 
cessation among Danish employees. METHODS: Data from 3,606 observations of
smokers gathered from the Danish National Work Environment Cohort Study in 1990, 
1995, and 2000 were analysed by logistic regression. The model comprised
background variables, smoking variables, and measures of psychosocial and other
aspects of the work environment. RESULTS: Statistically significant odds ratios
(OR) for cessation were found for medium versus no exposure to noise (OR 0.71,
95% CI 0.54-0.93), for high versus low physical workload (OR 0.49, 95% CI
0.47-0.73), for high versus low psychological demands (OR 1.42, 95% CI
1.12-1.80), and for medium versus low levels of responsibility at work (OR 1.31, 
95% CI 1.03-1.65). CONCLUSION: The probability of smoking cessation differs
between people with different exposures to certain work environmental factors.

PMID: 15204176 [PubMed - indexed for MEDLINE]


65. Health Rep. 2002 Jul;13(4):11-33.

Shift work and health.

Shields M.

Health Statistics Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
margotshieds@statcan.ca

OBJECTIVES: This article describes the characteristics of shift workers and
compares stress factors and health behaviours of shift and regular daytime
workers. Based on an analysis of people followed over four years, associations
between the incidence of chronic conditions and changes in psychological distress
levels are explored in relation to working shift. DATA SOURCES: Data are from the
2000/01 Canadian Community Health Survey, the longitudinal (1994/95, 1996/97 and 
1998/99) and cross-sectional (1994/95) components of the National Population
Health Survey, and the Survey of Work Arrangements (1991 and 1995). ANALYTICAL
TECHNIQUES: Cross-tabulations were used to profile shift workers and to compare
some of their health behaviours and sources of stress with those of regular
daytime workers. Multivariate analyses were used to examine associations between 
shift work and the incidence of chronic conditions and changes in psychological
distress levels over four years, controlling for other potential confounders.
MAIN RESULTS: Men who worked an evening, rotating or irregular shift had
increased odds of reporting having been diagnosed with a chronic condition over a
four-year period. For both sexes, an evening shift was associated with increases 
in psychological distress levels over two years.

PMID: 15069802 [PubMed - indexed for MEDLINE]


66. J Epidemiol Community Health. 2004 Apr;58(4):321-6.

Sickness absence as a predictor of mortality among male and female employees.

Vahtera J, Pentti J, Kivimäki M.

Finnish Institute of Occupational Health, Turku, Finland.
jussi.vahtera@occuphealth.fi

OBJECTIVE: To determine the extent to which sickness absence is predictive of
mortality. DESIGN: Prospective cohort study. Data on medically certified long
term absences (>3 days), self certified short term absences (1-3 days), and sick 
days were derived from employers' records and data on mortality from the national
mortality register. SETTING: 10 towns in Finland. PARTICIPANTS: 12821 male and
28915 female Finnish municipal employees with a job contract of five consecutive 
years. The mean follow up was 4.5 years. MAIN RESULTS: After adjustment for age, 
occupational status, and type of employment contract, the overall mortality rate 
was 4.3 (95% confidence intervals 2.6 to 7.0) and 3.3 (2.1 to 5.3) times greater 
in men and women with more than one long term absences per year than in those
with no absence. The corresponding hazard ratios for more than 15 annual sick
days were 4.7 (2.3 to 9.6) and 3.7 (1.5 to 9.1). Both these measures of sickness 
absence were also predictive of deaths from cardiovascular disease, cancer,
alcohol related causes, and suicide. Associations between short term sickness
absences and mortality were weaker and changed to non-significant after
adjustment for long term sickness absence. CONCLUSIONS: These findings suggest
that measures of sickness absence, such as long term absence spells and sick
days, are strong predictors of all cause mortality and mortality due to
cardiovascular disease, cancer, alcohol related causes, and suicide.

PMCID: PMC1732735
PMID: 15026447 [PubMed - indexed for MEDLINE]


67. Soc Sci Med. 2004 May;58(10):1889-901.

Tinker, tailor, soldier, patient: work attributes and depression disparities
among young adults.

Zimmerman FJ, Christakis DA, Vander Stoep A.

Department of Health Services, School of Public Health, University of Washington,
USA. fzimmer@u.washington.edu

Prior studies have consistently found the occurrence of depression to be higher
among persons with lower socio-economic status (SES), but causal mechanisms for
this relationship are often not well understood. For example, while depression
has been shown to increase during spells of unemployment, little work has been
done on job attributes that may be related to depression among employed people
early in their careers. This study links the 1992 wave of the National
Longitudinal Survey of Youth 1979 cohort-which included Depression symptom scores
on the Center for Epidemiologic Studies Depression (CES-D) instrument-to the US
Department of Labor's new occupational characteristics O*Net dataset. The
resulting dataset includes information regarding depression, SES, and specific
attributes of jobs held by the young adult respondents. Job attributes included
measures of social status, interpersonal stressors, and physical conditions.
Multivariate analysis revealed that for young men, higher job status is
associated with lower CES-D scores. Higher scores on the opposition scale, which 
measures the extent to which employees are obliged to take a position opposed to 
others, is associated with higher CES-D scores. For young women, physically
uncomfortable or dangerous jobs are associated with more depressive symptoms.
Results are stratified by race/ethnicity. For Black men, unlike for White men or 
Latinos, job security is associated with fewer depressive symptoms; and for
Latino men, but not for Black or White men, physically uncomfortable or dangerous
jobs are associated with more depressive symptoms. For Black women, job status is
associated with fewer depressive symptoms. We conclude that part of the
SES-depression relationship may arise from the psychosocial aspects of jobs,
which we have found to be significantly and meaningfully associated with
depressive symptoms among employed young adults.

PMID: 15020006 [PubMed - indexed for MEDLINE]


68. Pediatr Blood Cancer. 2004 Mar;42(3):230-40.

Self-concept in adult survivors of childhood acute lymphoblastic leukemia: a
cooperative Children's Cancer Group and National Institutes of Health study.

Seitzman RL, Glover DA, Meadows AT, Mills JL, Nicholson HS, Robison LL, Byrne J, 
Zeltzer LK.

Department of Pediatrics, University of California at Los Angeles, California,
USA. seitzman@ucla.edu

BACKGROUND: Self-concept was compared between adult survivors of childhood acute 
lymphoblastic leukemia (ALL) and sibling controls. Adult survivor subgroups at
greatest risk for negative self-concept were identified. PROCEDURE: Survivors (n 
= 578) aged > or =18 years, treated before age 20 years on Children's Cancer
Group (CCG) ALL protocols, and 396 sibling controls completed a telephone
interview and the Harter Adult Self-Perception Profile (ASPP). RESULTS: Survivors
global self-worth scores were significantly lower than sibling controls (mean
3.09 vs. 3.18; P = 0.022). Unemployed survivors reported lower global self-worth 
scores than employed (mean 2.77 vs. 3.12; P = 0.0001), whereas employment status 
was not associated with self-worth in controls. Among survivors, predictors of
negative self-concept included unemployment (odds ratio (OR) = 2.87; 95% CI:
1.50-5.50), and believing that cancer treatment limited employability (OR = 3.17;
95% CI: 1.79-5.62). Unemployment increased the odds for negative self-concept
among survivors who received combinations of central nervous system (CNS)
irradiation (CRT) and intrathecal methotrexate (IT-MTX), except high CRT with no 
or low dose IT-MTX. Employed survivors who perceived that treatment limited their
employability showed increased odds of negative self-concept for all treatment
groups compared to those who did not. Minority ethnic group membership was a
borderline significant predictor of negative self-concept (OR = 1.79; 95% CI:
0.94-3.33). CONCLUSIONS: Global self-worth was significantly lower in ALL
survivors than sibling controls, however, 81% of survivors had positive
self-concept. Survivor subgroups most vulnerable to negative self-concept were
the unemployed survivors, believing that cancer treatment affected employability,
and ethnic minority group members. Targeted intervention may have greater
clinical relevance for these subgroups. Copyright 2003 Wiley-Liss, Inc.

PMID: 14752860 [PubMed - indexed for MEDLINE]


69. J Adolesc Health. 2004 Jan;34(1):79-87.

Why is work intensity associated with heavy alcohol use among adolescents?

Paschall MJ, Flewelling RL, Russell T.

Prevention Research Center, 1995 University Avenue, Suite 450, Berkeley, CA
95704, USA. paschall@pire.org

PURPOSE: To examine and explain the relationship between work intensity (number
of hours worked per week) and heavy alcohol use among adolescents. METHODS:
Analyses were conducted with two waves of in-home interview data provided by a
representative sample of adolescents who participated in the National
Longitudinal Study of Adolescent Health. Multinomial logistic regression analyses
were conducted to determine whether a higher level of work intensity at Wave 1
predicted a higher level of past-year heavy drinking approximately 1 year later
at Wave 2, and the degree to which the relationship between work intensity and
heavy drinking persisted after adjusting for demographic characteristics, alcohol
use before Wave 1, and psychosocial risk and protective factors in family,
school, and peer-individual domains. RESULTS: Higher levels of work intensity at 
Wave 1 (11-20 or more than 20 hours/week) were predictive of heavy drinking at
Wave 2. However, these effects were substantially attenuated after adjusting for 
demographic characteristics and prior alcohol use. Risk and protective factors
such as school commitment, friends' drinking, and delinquency also partially
explained the effects of work intensity and background variables on heavy
drinking, suggesting that these factors may act as confounders and/or mediators. 
CONCLUSIONS: This study suggests that working more than 10 h/week increases the
likelihood of heavy alcohol use among adolescents, and that the effect of work
intensity is largely, but not completely attributable to demographic
characteristics (e.g., age, race/ethnicity, personal income), prior alcohol use, 
and family, school, and peer-individual factors.

PMID: 14706409 [PubMed - indexed for MEDLINE]


70. Acta Psychiatr Scand. 2003 Nov;108(5):350-8.

Attempted suicide among young people: risk factors in a prospective register
based study of Danish children born in 1966.

Christoffersen MN, Poulsen HD, Nielsen A.

The Danish National Institute of Social Research, Copenhagen K, Denmark.
mc@sfi.dk

OBJECTIVE: In order to prevent suicidal behaviour among adolescents and young
adults it would be valuable to know if altering the conditions of their
upbringing could reduce their suicidal behaviour. The study surveys possible risk
factors. METHOD: Population-based registers covering children born in Denmark in 
1966 at the age span of 14-27 years and their parents for: health, education,
family dissolution, suicidal behaviour, substance abuse, criminality and
unemployment. A discrete-time proportional hazard modelling was used to analyse
the longitudinal observations. RESULTS: First-time suicide attempts were
associated with parental psychiatric disorder, suicidal behaviour, violence,
child abuse and neglect. Increased risks were also found among adolescents and
young adults who suffered from psychiatric disorder or physical handicap, had
been legally imprisoned, were addicted to drugs, or without graduation,
vocational training or employment. CONCLUSION: Stigmatization, social exclusion, 
and mental disorders in the adolescents or young adults and parents increased
risks for attempted suicide.

PMID: 14531755 [PubMed - indexed for MEDLINE]


71. N Engl J Med. 2003 Aug 14;349(7):640-9.

Extended follow-up of long-term survivors of childhood acute lymphoblastic
leukemia.

Pui CH, Cheng C, Leung W, Rai SN, Rivera GK, Sandlund JT, Ribeiro RC, Relling MV,
Kun LE, Evans WE, Hudson MM.

Department of Hematology-Oncology, St. Jude Children's Research Hospital,
Memphis, TN 38105, USA. ching-hon.pui@stjude.org

Erratum in:
    N Engl J Med. 2003 Sep 25;349(13):1299.

Comment in:
    N Engl J Med. 2003 Aug 14;349(7):627-8.
    N Engl J Med. 2003 Nov 13;349(20):1973; author reply 1973.

BACKGROUND: Children who survive acute lymphoblastic leukemia are at risk for
leukemia-related or treatment-related complications, which can adversely affect
survival and socioeconomic status. We determined the long-term survival and the
rates of health insurance coverage, marriage, and employment among patients who
had attained at least 10 years of event-free survival. METHODS: A total of 856
eligible patients were treated between 1962 and 1992 in 13 consecutive clinical
trials. Survival rates, the cumulative risk of a second neoplasm, and selected
indicators of socioeconomic status were analyzed for the entire group and for
patients who did or did not receive cranial or craniospinal radiation therapy
during initial treatment. RESULTS: Fifty-six patients had major adverse events,
including 8 deaths during remission, 4 relapses, and 44 second neoplasms (41 of
them radiation-related); most of the second neoplasms were benign or of a low
grade of malignant potential. The risk of a second neoplasm was significantly
higher in the 597 patients who received radiation therapy (irradiated group) than
in the 259 patients who did not receive radiation therapy (nonirradiated group)
(P=0.04; estimated cumulative risk [+/-SE] at 20 years, 20.9+/-3.9 percent vs.
0.95+/-0.9 percent). The death rate for the irradiated group slightly exceeded
the expected rate in the general U.S. population (standardized mortality ratio,
1.90; 95 percent confidence interval, 1.12 to 3.00), whereas that for the
nonirradiated group did not differ from the population norm (standardized
mortality ratio, 1.75; 95 percent confidence interval, 0.34 to 5.00). The rates
of health insurance coverage, marriage, and employment in the nonirradiated group
were similar to the age- and sex-adjusted national averages. Despite having
health insurance rates similar to those in the general population, men and women 
in the irradiated group had higher-than-average unemployment rates (15.1 percent 
vs. 5.4 percent and 35.4 percent vs. 5.2 percent, respectively), and women in the
irradiated group were less likely to be married (35.2 percent vs. 48.8 percent). 
CONCLUSIONS: Children with acute lymphoblastic leukemia who did not receive
radiation therapy and who have attained 10 or more years of event-free survival
can expect a normal long-term survival. Irradiation is associated with the
development of second neoplasms, a slight excess in mortality, and an increased
unemployment rate. Copyright 2003 Massachusetts Medical Society

PMID: 12917300 [PubMed - indexed for MEDLINE]


72. Addiction. 2003 Aug;98(8):1111-7.

Four-year follow-up of smoke exposure, attitudes and smoking behaviour following 
enactment of Finland's national smoke-free work-place law.

Heloma A, Jaakkola MS.

Finnish Institute of Occupational Health, Helsinki, Finland. Antero.Heloma@ttl.fi

AIMS: This study evaluated the possible impact of national smoke-free work-place 
legislation on employee exposure to environmental tobacco smoke (ETS), employee
smoking habits and attitudes on work-place smoking regulations. DESIGN: Repeated 
cross-sectional questionnaire surveys and indoor air nicotine measurements were
carried out before, and 1 and 3 years after the law had come into effect.
SETTING: Industrial, service sector and office work-places from the Helsinki
metropolitan area, Finland. PARTICIPANTS: A total of 880, 940 and 659 employees
(response rates 70%, 75% and 75%) in eight work-places selected from a register
kept by the Uusimaa Regional Institute of Occupational Health to represent
various sectors of public and private work-places. MEASUREMENTS: Reported
exposure to ETS, smoking habits, attitudes on smoking at work and measurements of
indoor air nicotine concentration. FINDINGS: Employee exposure to ETS for at
least 1 hour daily decreased steadily during the 4-year follow-up, from 51% in
1994 to 17% in 1995 and 12% in 1998. Respondents' daily smoking prevalence and
tobacco consumption diminished 1 year after the enforcement of legislation from
30% to 25%, and remained at 25% in the last survey 3 years later. Long-term
reduction in smoking was confined to men. Both smokers' and non-smokers'
attitudes shifted gradually towards favouring a total ban on smoking at work.
Median indoor airborne nicotine concentrations decreased from 0.9 micro g/m3 in
1994-95 to 0.1 micro g/m3 in 1995-96 and 1998. CONCLUSIONS: This is the first
follow-up study on a nationally implemented smoke-free work-place law. We found
that such legislation is associated with steadily reducing ETS exposure at work, 
particularly at work-places, where the voluntary smoking regulations have failed 
to reduce exposure. The implementation of the law also seemed to encourage
smokers to accept a non-smoking work-place as the norm.

PMID: 12873245 [PubMed - indexed for MEDLINE]


73. Rheumatology (Oxford). 2003 Oct;42(10):1216-25. Epub 2003 Jun 16.

Prognostic factors in lateral epicondylitis: a randomized trial with one-year
follow-up in 266 new cases treated with minimal occupational intervention or the 
usual approach in general practice.

Haahr JP, Andersen JH.

Department of Occupational Medicine, Herning Hospital, Denmark. hecjph@ringamt.dk

OBJECTIVES: To determine whether minimal intervention by occupational specialists
involving information about the disorder, encouragement to stay active and
instruction in graded self-performed exercises could enhance the prognosis of
lateral epicondylitis compared with the treatment usually given in general
practice, to quantify workplace factors associated with the prognosis, and to
consider treatments given in general practice. METHODS: A randomized controlled
trial was performed in a cohort of 266 consecutive new cases of lateral
epicondylitis diagnosed in general practice. Workplace factors were assessed with
questionnaires at the time of inclusion, and patients completed follow-ups at 3, 
6 and 12 months. Status at 1 yr was assessed as overall improvement and pain
reduction compared with the time of diagnosis. General practitioners (GPs)
registered the treatments given for both cases and controls during follow-up.
Numbers of contacts with GPs and physiotherapists were obtained from the National
Health Insurance registry. Prognostic factors were analysed by multiple logistic 
regression analysis. RESULTS: After 1 yr, 83% of cases showed improvement in the 
condition, but the intervention was found to have had no advantage. Poor overall 
improvement was associated with employment in manual jobs [odds ratio (OR) 3.0,
95% confidence interval (CI) 1.0-8.7], a high level of physical strain at work
(OR 8.5, CI 1.0-74.7) and a high level of pain at baseline (OR 2.3, CI 1.0-5.3). 
Pain reduction less than 50% was associated with manual jobs (OR 2.3, CI
1.1-5.1), high physical strain at work (OR 3.6, CI 1.0-12.9), high baseline
distress (OR 1.9, CI 1.0-4.0) and tennis elbow on the dominant side (OR 3.1, CI
1.4-6.8). The intervention group received less treatment and fewer treatment
modalities, but the intervention was not followed by a reduction in the number of
visits to GPs and physiotherapist clinics during 12 months of follow-up.
CONCLUSIONS: Poor prognosis at 1 yr of follow-up for lateral epicondylitis was
related to manual work and high baseline pain, whilst no relation was found
between the type of medical treatment given/chosen and prognosis. This may have
implications for the future management of lateral epicondylitis in terms of a
greater focus on interaction with the workplace regarding job modification to
reduce physical demands during recovery.

PMID: 12810936 [PubMed - indexed for MEDLINE]


74. Am J Psychiatry. 2003 May;160(5):939-46.

Family disruption in childhood and risk of adult depression.

Gilman SE, Kawachi I, Fitzmaurice GM, Buka SL.

Department of Maternal and Child Health, Harvard School of Public Health, 677
Huntington Avenue, Boston, MA 02115, USA. sgilman@hsph.harvard.edu

OBJECTIVE: The authors examined the risk that family disruption and low
socioeconomic status in early childhood confer on the onset of major depression
in adulthood. METHOD: Participants were 1,104 offspring of mothers enrolled
during pregnancy in the Providence, R.I., site of the National Collaborative
Perinatal Project. Measures of childhood family disruption and socioeconomic
status were obtained before birth and at age 7. Structured diagnostic interviews 
were used to assess respondents' lifetime history of major depressive episode
between the ages of 18 and 39. Survival analysis was used to identify childhood
risks for depression onset. RESULTS: Parental divorce in early childhood was
associated with a higher lifetime risk of depression among subjects whose mothers
did not remarry as well as among subjects whose mothers remarried. These effects 
were more pronounced when accompanied by high levels of parental conflict.
Independent of the respondents' adult socioeconomic status, low socioeconomic
status in childhood predicted an elevated risk of depression. CONCLUSIONS: Family
disruption and low socioeconomic status in early childhood increase the long-term
risk for major depression. Reducing childhood disadvantages may be one avenue for
prevention of depression. Identification of modifiable pathways linking aspects
of the early childhood environment to adult mental health is needed to mitigate
the long-term consequences of childhood disadvantage.

PMID: 12727699 [PubMed - indexed for MEDLINE]


75. Scand J Work Environ Health. 2003 Feb;29(1):5-14.

Factors influencing the impact of unemployment on mental health among young and
older adults in a longitudinal, population-based survey.

Breslin FC, Mustard C.

Institute for Work & Health, Toronto, ON, Canada. cbreslin@iwh.on.ca

OBJECTIVES: This study examined the relationship between unemployment and mental 
health. It particularly emphasized the potential differences in mental health
status between younger workers entering the labor market and older workers with
established laborforce involvement. METHODS: With the use of the National
Population Health Survey in Canada, over 6000 respondents between 18 and 55 years
of age in 1994 were followed up 2 years later. RESULTS: The results suggest that,
among the 31- to 55-year-olds, becoming unemployed led to increases in distress
and, to some extent, clinical depression at follow-up. This association between
unemployment and mental health was not found among younger adults 18 to 30 years 
of age. Possible explanations for the null finding among young adults, such as
decreased likelihood of low household income or increased likelihood of
distressed young adults completely withdrawing from the workforce, were not
supported. The notion that baseline mental health affects the chances of being
unemployed at the time of a 24-month follow-up were partially supported.
CONCLUSIONS: These findings from a representative sample suggest that both
causation and selection processes lead to an association between unemployment and
distress among older adults.

PMID: 12630430 [PubMed - indexed for MEDLINE]


76. J Asthma. 2002 Dec;39(8):729-36.

Relationships between self-reported asthma utilization and patient
characteristics.

Tinkelman DG, McClure DL, Lehr TL, Schwartz AL.

Health Initiatives, National Jewish Medical and Research Center, Denver, Colorado
80206, USA. tinkelmand@njc.org

BACKGROUND: Identifying asthmatic individuals most likely to utilize medical care
in the future will help to direct intervention and medical resources; however,
there are currently limited models for future utilization. OBJECTIVE: This study 
investigated the relationship between patient characteristics and medical
utilization, using an asthma disease management patient population. METHODS: We
analyzed a sample of 1412 adults, enrolled for 6 months in an asthma disease
management program, for relationships with utilization. Individuals answered
demographic, socioeconomic, and medical questions via telephonic contact upon
enrollment. Follow-up regarding medical utilization occurred during the
subsequent 6 months. Relationships between utilization and enrollment answers
were statistically modeled. RESULTS: Oral steroid bursts, day and night symptom
frequencies, age, gender, education level, and employment status all had a
significant relationship to medical utilization. Those individuals who had used
oral steroids 6 months prior to enrollment, patients with more than five
night-time asthma symptoms per month, and those with "continuous" day symptoms
were more likely to report utilization. Those patients under 44 years old,
females, those who were not high school graduates, and patients who defined
themselves as unemployed because of their asthma were also more likely to report 
utilization. While those unemployed because of asthma were already more likely to
report utilization, individuals in the 45+ age category were more likely than
those 18-44. CONCLUSIONS: Identifying asthma patients likely to utilize medical
care is feasible, although more investigation is needed to demonstrate
applicability to a general asthma population.

PMID: 12507193 [PubMed - indexed for MEDLINE]


77. Am J Community Psychol. 2002 Dec;30(6):787-813.

Mental health and welfare transitions: depression and alcohol abuse in AFDC
women.

Dooley D, Prause J.

Department of Psychology and Social Behavior, School of Social Ecology,
University of California, Irvine 92697, USA. cddooley@uci.edu

From a selection perspective, does prior dysfunction select women into welfare or
serve as a barrier to leaving welfare? From a social causation perspective, does 
entering or exiting welfare lead to changes in well being? These questions were
analyzed in panel data for over 3,600 women drawn from the National Longitudinal 
Survey of Youth for the period 1992-94. Welfare is associated with both
depression and alcohol consumption cross-sectionally. This link appears to derive
in small part from selection into welfare by depression (in interaction with
marital status), butdepression and alcohol abuse did not operate as barriers to
leaving welfare. Entering welfare was clearly associated with increased
depression and alcohol consumption, but confidence in an apparent beneficial
effect on alcohol symptoms of leaving welfare for employment was limited by small
sample sizes. These findings are located in the context of the 1996-welfare
reform and the recent economic expansion. One implication is that community
psychology should consider welfare entry as a risk factor similar to adverse
employment changes such as job loss.

PMID: 12385483 [PubMed - indexed for MEDLINE]


78. Int J Obes Relat Metab Disord. 2002 Oct;26(10):1329-38.

Unemployment and obesity among young adults in a northern Finland 1966 birth
cohort.

Laitinen J, Power C, Ek E, Sovio U, Järvelin MR.

Oulu Regional Institute of Occupational Health, Oulu, Finland.
jaana.laitinen@ttl.fi

OBJECTIVE: To establish (1) if obesity in adolescence predicts a long history of 
unemployment and other adverse social outcomes at age 31 y and, conversely, (2)
the effect of a long history of unemployment on the risk of obesity at 31 y.
DESIGN AND SUBJECTS: A longitudinal, population-based study of 9,754 subjects
born in 1966 in Northern Finland was conducted. The cohort members were studied
at birth, 1, 14 and 31 y. MEASUREMENTS: Body mass index (BMI) at 14 and 31 y;
work history, as self-reported at 31 y and as recorded in national registers of
the total number of days each subject had received unemployment allowance between
1985 and 1997; place of residence at 14 and 31 y; family social class at 14 y;
subject's school performance at 16 y; marital status and number of children at 31
y. RESULTS: Overweight and obesity at 14 y did not predict a long history of
unemployment at 31 y, but were associated with a low level of education, and
being single or divorced at 31 y among females. A long history of unemployment
(register data) was associated with an increased risk of obesity among women, but
not men, after controlling for potential confounding factors (social class at 14 
y, BMI at 14 y, school performance at 16 y, place of residence, and number of
children). The adjusted OR (95% CI) was 1.09 (0.72-1.63) for men, and 1.64
(1.07-2.50) for women. CONCLUSION: Adverse social outcomes of adolescent obesity 
seemed to emerge more for women. Subjects with low school performance and women
with a long unemployment history are at increased risk of obesity.

PMID: 12355341 [PubMed - indexed for MEDLINE]


79. East Afr Med J. 2001 Nov;78(11):564-7.

Autologous transfusion in surgical patients at Kenyatta National Hospital,
Nairobi.

Magoha GA, Mwanda WO, Afulo OK.

Department of Surgery, College of Health Sciences, University of Nairobi.

Comment in:
    East Afr Med J. 2001 Nov;78(11):561-3.

OBJECTIVE: To identify autotransfusion strategies and their basis in elective
surgery patients. DESIGN: A cross sectional prospective study. SETTING: General
surgery and orthopaedic wards, Kenyatta National Hospital, Nairobi. SUBJECTS:
Adult patients of both sexes planned for elective surgery. MAIN OUTCOME MEASURE: 
Forevery patient, the following were enquired about and documented: age in years,
sex, ethnicity, religion, occupation and educational standard. Blood values of
haemoglobin, platelet counts, total and differential white cell counts, urea,
electrolytes and liver function tests were assayed. Others were the number of
units of blood donated before the operation, the type of surgery performed, time 
taken from diagnosis to performing the operation and whether the blood was
transfused preoperatively, intraoperatively and postoperatively. RESULTS: A total
of sixty three cases constituting five per cent of all surgical patients admitted
during the period of study were evaluated. Of these 53 (84%) were males and ten
(16%) females. The age range was 15 to 65 years with a peak at 45-49 years. There
were more Christians (90%) than Muslims (10%). In all, 32 (51.6%) had primary
school education, 23 (36.5%) secondary school education, seven (11.3%) no formal 
education and one (1.6%) had attained college level. Employment pattern showed
50% were civil servants, 30% were self employed and 20% were unemployed. The
duration of disease ranged from 1-24 weeks with two peaks at two weeks and six
weeks. Orthopaedic cases constituted 78.7% and general surgery 21.3%.
Preoperative haemoglobin ranged from 13.5-14.2 g/dl. Transfusions were given
intraoperatively to 41 (66.1%) and to 12 (33.9%) postoperatively. Mean duration
of hospitalisation was 13 days (range 5 to 21 days). 98.4% deposited only one
unit while 1.6% deposited four units of blood. Only one patient required
additional transfusion from homologous donors. CONCLUSION: The strategies and
basis for autotransfusion have been demonstrated among a majority of adult
patients requiring orthopaedic procedures. Major determinants are shown to be
baseline blood count profiles and time to operation.

PMID: 12219960 [PubMed - indexed for MEDLINE]


80. Soc Sci Med. 2002 Mar;54(5):677-92.

The influence of work, household structure, and social, personal and material
resources on gender differences in health: an analysis of the 1994 Canadian
National Population Health Survey.

Walters V, McDonough P, Strohschein L.

Department of Sociology, McMaster University, Hamilton, ON, Canada.
walterv@mcmaster.ca

Data from the 1994 Canadian National Population Health Survey (NPHS) do not
confirm the widespread assumption that women experience considerably more ill
health than men. The patterns vary by condition and age and at many ages, the
health of women and men is more similar than is often assumed. However, we should
not minimize the gender differences that do exist and in this paper we focus on
three health problems which are more common among women: distress, migraine and
arthritis/rheumatism. We consider to what extent work, household structure and
social, personal and material resources explain these gender differences in
health. Analysis of the distributions of paid work conditions, household
circumstances and resources reveal mostly minor differences by gender and
differences in exposure to these circumstances contribute little to understanding
gender differences in health. There is also little evidence that greater
vulnerability is a generalized health response of women to paid and household
circumstances. We find limited evidence that social, personal and material
resources are involved in pathways linking work and home circumstances to health 
in ways that differ between the sexes. In conclusion, we consider some reasons
for the lack of support for our explanatory model: the measures available in the 
NPHS data set which contains little information on the household itself; the
difficulty of separating 'gender' from the social and material conditions of
men's and women's lives; and changes in women's and men's roles which may have
led to a narrowing of differences in health.

PMID: 11999486 [PubMed - indexed for MEDLINE]


81. Int J Epidemiol. 2002 Apr;31(2):336-41.

Accumulated labour market disadvantage and limiting long-term illness: data from 
the 1971-1991 Office for National Statistics' Longitudinal Study.

Bartley M, Plewis I.

Department of Epidemiology and Public Health, University College London, 1-19
Torrington Place, London WC1E 6BT, UK.

BACKGROUND: Both social class and unemployment have been shown in many studies to
be related to ill health. Recent work in social epidemiology has demonstrated the
importance of examining the accumulation of disadvantage over the life course.
This paper therefore uses a large longitudinal data set to examine the
accumulation of both disadvantaged class and unemployment over a 20-year period
in a representative sample of the male working population of England and Wales.
METHODS: Logistic regression. RESULTS: Both membership of semi- or unskilled
social class and unemployment in 1971 were related to limiting long-term illness 
(LLTI) in 1991 independently of each other, and of subsequent social class and
unemployment. Any occurrence of disadvantaged social class or of unemployment
added significantly to the risk of LLTI. A labour market disadvantage score
comprising the number of occasions on which a study member had been either in a
disadvantaged social class or unemployed showed a clear and graded relationship
to illness, with odds of 4 to 1 in the worst-scoring group. CONCLUSION: The
experiences of disadvantaged social class or unemployment at any time during this
period contributed independently to an increased risk of chronic limiting illness
up to 20 years later in the life course. Whereas improvements in social
conditions at any one time will lessen the long-term combined impact of
accumulated labour market disadvantage on health, it may not prove easy to obtain
short term improvements in health inequality.

PMID: 11980794 [PubMed - indexed for MEDLINE]


82. Health Serv Res. 2002 Feb;37(1):173-86.

Family structure, socioeconomic status, and access to health care for children.

Heck KE, Parker JD.

Infant and Child Health Studies Branch, Office of Analysis, Epidemiology and
Health Promotion, National Center for Health Statistics, Sacramento, CA 95814,
USA.

OBJECTIVE: To test the hypothesis that among children of lower socioeconomic
status (SES), children of single mothers would have relatively worse access to
care than children in two-parent families, but there would be no access
difference by family structure among children in higher SES families. DATA
SOURCES: The National Health Interview Surveys of 1993-95, including 63,054
children. STUDY DESIGN: Logistic regression was used to examine the relationship 
between the child's family structure (single-mother or two-parent family) and
three measures of health care access and utilization: having no physician visits 
in the past year, having no usual source of health care, and having unmet health 
care needs. To examine how these relationships varied at different levels of SES,
the models were stratified on maternal education level as the SES variable. The
stratified models adjusted for maternal employment, child's health status, race
and ethnicity, and child's age. Models were fit to examine the additional effects
of health insurance coverage on the relationships between family structure,
access to care, and SES. PRINCIPAL FINDINGS: Children of single mothers, compared
with children living with two parents, were as likely to have had no physician
visit in the past year; were slightly more likely to have no usual source of
health care; and were more likely to have an unmet health care need. These
relationships differed by mother's education. As expected, children of single
mothers had similar access to care as children in two-parent families at high
levels of maternal education, for the access measures of no physician visits in
the past year and no usual source of care. However, at low levels of maternal
education, children of single mothers appeared to have better access to care than
children in two-parent families. Once health insurance was added to adjusted
models, there was no significant socioeconomic variation in the relationships
between family structure and physician visits or usual source of care, and there 
were no significant disparities by family structure at the highest levels of
maternal education. There were no family structure differences in unmet needs at 
low maternal education, whereas children of single mothers had more unmet needs
at high levels of maternal education, even after adjustment for insurance
coverage. CONCLUSIONS: At high levels of maternal education, family structure did
not influence physician visits or having a usual source of care, as expected.
However, at low levels of maternal education, single mothers appeared to be
better at accessing care for their children. Health insurance coverage explained 
some of the access differences by family structure. Medicaid is important for
children of single mothers, but children in two-parent families whose mothers are
less educated do not always have access to that resource. Public health insurance
coverage is critical to ensure adequate health care access and utilization among 
children of less educated mothers, regardless of family structure.

PMID: 11949919 [PubMed - indexed for MEDLINE]


83. J Am Med Womens Assoc. 2002 Winter;57(1):5-10.

What causes job loss among former welfare recipients: the role of family health
problems.

Earle A, Heymann SJ.

Department of Health and Social Behavior, Harvard School of Public Health, USA.

OBJECTIVE: to test whether women's or children's health status influences the
likelihood that low-income single mothers experience job loss. METHODS: Using a
nationally representative probability sample from the National Longitudinal
Survey of Youth, we estimated whether having a health limitation or having a
child with a health limitation was associated with job loss for a sample of 783
women who had previously been on welfare. RESULTS: Both having a health
limitation (odds ratio [OR]=1.53; 95% confidence interval [CI], 1.19-1.97) and
having a child with a health limitation (OR=1.36; 95% CI, 1.18-1.56) were
associated with significantly increased risk of job loss among women previously
on welfare. The effects remained significant after adjustment for age, education,
marital status, race, age and number of children, and economic conditions.
CONCLUSIONS: Dramatic changes in welfare policy in the United States have made
many single mothers living in poverty dependent on work as their sole source of
income. Although studies have shown that families on welfare are more likely to
have health limitations, little is known about how family health affects the
ability of poor single mothers to remain employed. These results demonstrate that
women with health limitations and mothers of children with health limitations are
at particularly high risk of losing their jobs. Public and private policies that 
can help reduce job loss as a consequence of family health problems are
discussed.

PMID: 11905494 [PubMed - indexed for MEDLINE]


84. Am J Community Psychol. 2001 Dec;29(6):907-36.

Multidimensional profiles of welfare and work dynamics: development, validation, 
and associations with child cognitive and mental health outcomes.

Yoshikawa H, Seidman E.

Department of Psychology, New York University, New York 10003, USA.
hiro.yoshikawa@nyu.edu

This prospective longitudinal study addresses the research gap in the literature 
regarding multidimensional variation in welfare use and employment patterns, and 
relationships of such variation with parent earnings and child development
outcomes. This study also aims to address the limitations of welfare dynamics
studies that do not examine how multiple dimensions of welfare receipt and
employment co-occur Cluster analysis was utilized, using monthly welfare and
employment data from the National Longitudinal Survey of Youth, to examine
variation within the welfare population in their welfare and work patterns across
the first 5 years of children's lives. Six cluster profiles of welfare and work
dynamics were found: Short-Term, Short-Term Work Exit, Working Cyclers,
Nonworking Cyclers, Cycle to Long-Term Exit, and Long-Term. The clusters were
validated using mother's 6th-year earnings as the criterion. The clusters'
associations with child development outcomes in the cognitive and mental health
domains (at ages 6 and 7) were then explored. Work following short-term welfare
use was associated with higher child reading scores than that following long-term
use (a moderate-size effect). Cycling on and off welfare in the context of high
levels of employment was associated with higher child internalizing symptoms than
cycling accompanied by low levels of employment (a moderate-size effect).
Implications for evaluation of TANF welfare-to-work policies are discussed.

PMID: 11800512 [PubMed - indexed for MEDLINE]


85. Scand J Public Health. 2001 Dec;29(4):263-70.

Sociodemographic predictors of self-rated health in patients with diabetes of
short duration.

Jonsson PM, Nyström L, Sterky G, Wall S.

Department of Public Health Sciences, Division of International Health (IHCAR),
Karolinska Institutet, Stockholm, Sweden. pia.maria.jonsson@phs.ki.se

AIMS: To examine the impact of gender and socioeconomic factors on health-related
quality of life (HRQoL) one year and eight years after diabetes diagnosis.
METHODS: Two national incidence cohorts who contracted diabetes between the ages 
of 15 and 34 years (n=554) and matched control groups from the general population
of Sweden (n=1,029) were surveyed. Data on HRQoL, diabetes treatment, marital
status, education, social class, and employment were collected via a
questionnaire mailed to the younger cohort (aged 16-35) one year after diagnosis 
and to the older cohort (aged 23-42) eight years after diagnosis. Response rates 
were 73% among people with diabetes and 68% among the controls. Multivariable
linear regression models were used to analyse the impact of gender and
socioeconomic factors on HRQoL in the diabetic and control groups. The dependent 
variable was the "general health perceptions" score of the SWED-QUAL instrument, 
which corresponds to the "global self-rated health" concept. RESULTS: A model
including all the sociodemographic variables explained 6% of the variance in
self-rated health one year after diabetes diagnosis and 13% of the variance eight
years after diagnosis. In the control groups, the level of explanation was 2-3%. 
Female gender was an independent predictor of poor self-rated health in the older
diabetic cohort, but not in the younger cohort. CONCLUSIONS: Gender and
socioeconomic factors were more closely associated with self-rated health eight
years after diabetes diagnosis than one year after diagnosis, indicating early
sociodemographic stratification in the health of the diabetic populations
studied.

PMID: 11775782 [PubMed - indexed for MEDLINE]


86. Can J Psychiatry. 2001 Sep;46(7):632-8.

Alcohol consumption and major depression: findings from a follow-up study.

Wang J, Patten SB.

Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie
University, 5849 University Ave, Halifax, NS.B3H 4H7. Jwang@tupdean2.med.dal.ca

OBJECTIVE: To investigate whether alcohol consumption predicts major depressive
disorder episodes (MDEs) in the general population. METHOD: The respondents
without depression (n = 12,290) in the longitudinal cohort of the Canadian
National Population Health Survey (NPHS) were classified into cohorts based on
any drinking, frequency of drinking, maximum number of drinks on a maximal
drinking occasion, and average daily alcohol consumption, based on data collected
in the 1994-1995 survey. Major depression frequency 2 years later, in 1996-1997, 
was evaluated and compared across drinking categories. RESULTS: The respondents
who reported any drinking, drinking daily, having more than 5 drinks on a maximal
drinking occasion, and having more than 1 drink daily on average, did not have an
elevated risk of major depression. A trend in the data suggested that women who
reported having more than 5 drinks on a maximal drinking occasion might be at a
higher risk of major depression. No evidence of confounding or effect
modification by demographic, psychological, and clinical variables was found.
CONCLUSION: In a general population sample, alcohol consumption levels were not
associated with major depression. Having more than 5 drinks on a maximal drinking
occasion, however, may be associated with an increased risk of major depression
among women. Extreme patterns of alcohol consumption, which tend to characterize 
clinical samples, are associated with depression. These patterns of drinking,
however, are relatively uncommon in the general population, and the current
analysis may have lacked power to detect these associations.

PMID: 11582825 [PubMed - indexed for MEDLINE]


87. Clin Pediatr (Phila). 2001 May;40(5):259-63.

A program description of health care interventions for homeless teenagers.

Steele RW, O'Keefe MA.

Department of Pediatrics, Louisiana State University School of Medicine and
Children's Hospital, New Orleans 70118, USA.

This prospective review was designed to determine the effectiveness of a
broad-spectrum health intervention program for homeless and runaway youth.
Diagnosis, treatment, and counseling for drug use, sexually transmitted diseases 
(STDs), and other health issues were provided all new admissions to a residential
care facility during a 2-month enrollment. Education was continued during a
9-month follow-up period based on the program entitled Bright Futures, previously
developed and published by the National Center for Education in Maternal and
Child Health. Sixty percent of the 106 study residents had STDs on admission and 
7% developed new STDs after completing therapy and undergoing counseling. Drug
dependence was reduced from 41% to 3%, and 42% achieved full-time or part-time
employment. Fifty-nine percent completed hepatitis B immunization with the 3-dose
series. This experience suggests that an organized program of interventions in a 
residential care facility for homeless teenagers can significantly reduce drug
dependence and STDs.

PMID: 11388675 [PubMed - indexed for MEDLINE]


88. Soc Sci Med. 2001 Jun;52(11):1741-50.

Transitions of employment status among suicide attempters during a severe
economic recession.

Ostamo A, Lahelma E, Lönnqvist J.

Department of Mental Health and Alcohol Research, National Public Health
Institute, Helsinki, Finland. aini.ostamo@ktl.fi

Previous studies have shown a positive association between unemployment and
attempted suicide. This study investigated transitions of employment status among
suicide attempters during the severe economic recession. The main research
question was whether inequality in the labour market also prevails among as
selected a population as suicide attempters. The material consisted of 2495
persons who attempted suicide during 1989-1994 in Helsinki, Finland. Logistic
regression analysis and survival analysis were used. Unemployment rates among
suicide attempters were higher than in the general population, male rates being
higher than female rates throughout the recession. There were significant changes
in the employment status of the entire attempted suicide population from 1989 to 
1994, especially in terms of the transition from employment to unemployment.
Gender, age and education level predicted exit from the labour market. Among
suicide attempters young middle-aged men with low education had the highest risk 
of unemployment.

PMID: 11327145 [PubMed - indexed for MEDLINE]


89. J Health Soc Behav. 2000 Dec;41(4):421-36.

Underemployment and depression: longitudinal relationships.

Dooley D, Prause J, Ham-Rowbottom KA.

Department of Psychology and Social Behavior, School of Social Ecology,
University of California, Irvine, CA 92697, USA.

We conceptualize employment status not as a dichotomy of working versus not
working but as a continuum ranging from adequate employment to inadequate
employment (involuntary part-time or low wage) to unemployment. Will shifts from 
adequate to inadequate employment increase depression as do shifts from
employment to unemployment, and to what extent does prior depression select
workers into such adverse employment change? We analyze panel data from the
National Longitudinal Survey of Youth for the years 1992-1994 for the 5,113
respondents who were adequately employed in 1992. Controlling for prior
depression, both types of adverse employment change resulted in similar,
significant increases in depression. These direct effects persisted despite
inclusion of such potential mediators as changes in income, job satisfaction, and
marital status. Marital status buffered the depressive effect of both types of
adverse change, but education and job dissatisfaction amplified the effect of
unemployment on depression. Prior depression did not predict higher risk of
becoming inadequately employed but did predict increased risk of unemployment,
particularly for those with less education. These results confirm that both
unemployment and inadequate employment affect mental health, and they invite
greater efforts to monitor the extent and impact of underemployment.

PMID: 11198566 [PubMed - indexed for MEDLINE]


90. Subst Use Misuse. 2000 Oct-Dec;35(12-14):1849-77.

Services research outcomes study: overview of drug treatment population and
outcomes.

Schildhaus S, Gerstein D, Brittingham A, Cerbone F, Dugoni B.

National Opinion Research Center, University of Chicago, Washington Office,
District of Columbia 20036, USA.

The study examined a representative sample of the 1,060,000 individuals
discharged from drug user treatment in the United States in the 12 months before 
September 1990, and compared self-reports of behavior 5 years before to 5 years
after treatment. Self-reports about recent drug use were compared with urine
samples, and the agreement between self-report and drug-test results was high.
The key findings are that the number of alcohol and drug users declined markedly,
ranging from one-seventh to more than one half; those who continued using drugs
after treatment used them less frequently than before treatment; criminal
behavior fell between one-quarter to one-half, and primary criminal support fell 
by one third; full-time employment did not change; homelessness, drug injection, 
and suicide attempts decreased by more than one-third.

PMID: 11138710 [PubMed - indexed for MEDLINE]


91. Soc Sci Med. 2000 Oct;51(7):1019-30.

Social class and self-rated health: can the gradient be explained by differences 
in life style or work environment?

Borg V, Kristensen TS.

Department of Psychology and Sociology, National Institute of Occupational
Health, Copenhagen O, Denmark. vb@ami.dk

The purpose of the present paper is to describe differences in work environment
and life style factors between social classes in Denmark and to investigate to
what extent these factors can explain social class differences with regard to
changes in self-rated health (SRH) over a 5 year period. We used data from a
prospective study of a random sample of 5001 Danish employees, 18-59 years of
age, interviewed at baseline in 1990 and again in 1995. At baseline we found
higher prevalence in the lower classes of repetitive work, low skill discretion, 
low influence at work, high job insecurity, and ergonomic, physical, chemical,
and climatic exposures. High psychological demands and conflicts at work were
more prevalent in the higher classes. With regard to life style factors, we found
more obese people and more smokers among the lower classes. The proportion with
poor SRH increased with decreasing social class at baseline. The follow-up
analyses showed a clear association between social class and worsening of SRH:
The lower the social class, the higher the proportion with deterioration of SRH. 
There was no social gradient with regard to improved SRH over time. Approximately
two thirds of the social gradient with regard to worsening of SRH could be
explained by the work environment and life style factors. The largest
contribution came from the work environment factors.

PMID: 11005390 [PubMed - indexed for MEDLINE]


92. Epilepsia. 2000 Jun;41(6):760-4.

Relationships between seizure severity and health-related quality of life in
refractory localization-related epilepsy.

Vickrey BG, Berg AT, Sperling MR, Shinnar S, Langfitt JT, Bazil CW, Walczak TS,
Pacia S, Kim S, Spencer SS.

University of California, Los Angeles, California, USA. The Multicenter Epilepsy 
Surgery Study. bvickrey@ucla.edu

PURPOSE: To evaluate relationships between self-report measures of seizure
severity and health-related quality of life (HRQOL) in people with refractory
localization-related epilepsy. METHODS: A sample of 340 adults enrolled in a
seven-center, prospective study of resective epilepsy surgery completed baseline 
questionnaires that included the Quality of Life in Epilepsy (QOLIE)-89 and a
seven-item adaptation of the National Hospital Seizure Severity Scale.
Associations between QOLIE-89 summary measures and both the total seizure
severity scale score and individual seizure severity items were assessed, after
adjustment for seizure frequency. RESULTS: The seizure severity measure had
adequate scale score variability and reliability in this sample. Correlations
between individual items in the scale did not exceed 0. 43. Product-moment
partial correlations between the seizure severity scale and QOLIE-89 summary
measures ranged from -0.17 to -0.29 (all p values <0.01). Of the seven seizure
severity items, the average time before individuals perceived they were "really
back to normal" after their seizures was broadly related to all domains of HRQOL 
(r values ranged from -0.16 to -0.30; p values <0.01). Severity of injury during 
seizures was the only other item having more than minimal associations with
HRQOL, and it was selectively related to the physical health measure. Higher
frequency of falls during seizures was modestly related to less employment.
CONCLUSIONS: This seizure severity measure assesses constructs that are generally
distinct from HRQOL, except for moderate and broad associations between HRQOL and
patient's perceptions of the average duration of recovery time after seizures.
Recovery time may potentially be a useful clinical indicator of seizure severity 
that reflects meaningful impairment of HRQOL in adults with frequent seizures.

PMID: 10840410 [PubMed - indexed for MEDLINE]


93. Int J STD AIDS. 2000 May;11(5):313-23.

Sexually transmitted infections and use of sexual health services among young
Australian women: women's health Australia study.

Schofield MJ, Minichiello V, Mishra GD, Plummer D, Savage J.

School of Health, University of New England, Armidale, New South Wales,
Australia.

Our objective was to examine associations between self-reported sexually
transmitted infections (STIs) and sociodemographic, lifestyle, health status,
health service use and quality of life factors among young Australian women; and 
their use of family planning and sexual health clinics and associations with
health, demographic and psychosocial factors. The study sample comprised 14,762
women aged 18-23 years who participated in the mailed baseline survey for the
Australian Longitudinal Study on Women's Health, conducted in 1996. The main
outcome measures are self report of ever being diagnosed by a doctor with an STI,
including chlamydia, genital herpes, genital warts or other STIs, and use of
family planning and sexual health clinics. The self-reported incidence of STI was
1.7% for chlamydia, 1.1% genital herpes, 3.1% genital warts, and 2.1% other STIs.
There was a large number of demographic, health behaviour, psychosocial and
health service use factors significantly and independently associated with
reports of having had each STI. Factors independently associated with use of
family planning clinic included unemployment, current smoking, having had a Pap
smear less than 2 years ago, not having ancillary health insurance, having
consulted a hospital doctor and having higher stress and life events score.
Factors independently associated with use of a sexual health clinic included
younger age, lower occupation status, being a current or ex-smoker, being a binge
drinker, having had a Pap smear, having consulted a hospital doctor, having
poorer mental health and having higher life events score. This study reports
interesting correlates of having an STI among young Australian women aged 18-23. 
The longitudinal nature of this study provides the opportunity to explore the
long-term health and gynaecological outcomes of having STIs during young
adulthood.

PMID: 10824940 [PubMed - indexed for MEDLINE]


94. Arch Gen Psychiatry. 2000 Apr;57(4):375-80.

Psychosocial disability during the long-term course of unipolar major depressive 
disorder.

Judd LL, Akiskal HS, Zeller PJ, Paulus M, Leon AC, Maser JD, Endicott J, Coryell 
W, Kunovac JL, Mueller TI, Rice JP, Keller MB.

National Institute of Mental Health Collaborative Program on the Psychobiology of
Depression, Rockville, MD, USA.

Comment in:
    Arch Gen Psychiatry. 2000 Apr;57(4):381-2.

BACKGROUND: The goal of this study was to investigate psychosocial disability in 
relation to depressive symptom severity during the long-term course of unipolar
major depressive disorder (MDD). METHODS: Monthly ratings of impairment in major 
life functions and social relationships were obtained during an average of 10
years' systematic follow-up of 371 patients with unipolar MDD in the National
Institute of Mental Health Collaborative Depression Study. Random regression
models were used to examine variations in psychosocial functioning associated
with 3 levels of depressive symptom severity and the asymptomatic status.
RESULTS: A progressive gradient of psychosocial impairment was associated with a 
parallel gradient in the level of depressive symptom severity, which ranges from 
asymptomatic to subthreshold depressive symptoms to symptoms at the minor
depression/dysthymia level to symptoms at the MDD level. Significant increases in
disability occurred with each stepwise increment in depressive symptom severity. 
CONCLUSIONS: During the long-term course, disability is pervasive and chronic but
disappears when patients become asymptomatic. Depressive symptoms at levels of
subthreshold depressive symptoms, minor depression/ dysthymia, and MDD represent 
a continuum of depressive symptom severity in unipolar MDD, each level of which
is associated with a significant stepwise increment in psychosocial disability.

PMID: 10768699 [PubMed - indexed for MEDLINE]


95. Dan Med Bull. 1999 Jun;46(3):269-72.

The Danish Prevention Register. A comprehensive health and socio-economic,
individual based register.

Roed AS, Juhl C, Kamper-Jorgensen F.

Ministry of Health, Copenhagen.

The Danish Prevention Register has been created recently as a very comprehensive 
national individual based register, based on register linkage. The Prevention
Register currently comprises eight registers, which have been linked together
using the unique personal identification number. The register contains data from 
1977 and onwards. From an international research perspective this register offers
unique opportunities to the researchers. The eight registers can be divided into 
three groups: health-related registers, registers on living conditions and a
Register of Population Statistics. The health-related registers are: Register of 
Causes of Death, National Patient Register (in-patients and out-patients) and
Register of Health Insurance Statistics (primary health care, GPs). Within the
next few years the register will be expanded with The Medical Birth Register. The
Abortion Register and The Malformation Register. The registers on living
conditions are: Longitudinal Register of Social and Employment Statistics,
Employment Classification Module, Educational Classification Module and Register 
of Population and Housing Censuses. The Register allows for cross-sectional and
follow-up studies and is used for administrative purposes as well as research
purposes. An overview of the register is presented in the article. Earlier
articles in the Danish Register series in DMB explain details of the registers.

PMID: 10421986 [PubMed - indexed for MEDLINE]


96. Soc Sci Med. 1999 May;48(10):1491-9.

The persisting effect of unemployment on health and social well-being in men
early in working life.

Wadsworth ME, Montgomery SM, Bartley MJ.

MRC National Survey of Health and Development, Department of Epidemiology and
Public Health, University College London Medical School, UK.
m.wadsworth@ucl.ac.uk

In our studies of the effects of unemployment in the early working life of men in
a British national birth cohort we have shown elsewhere that this experience was 
part of a longer term accumulation of social and health disadvantage. This
present study asks whether men's unemployment also inflicted potential longterm
damage to future socio-economic chances and health. We therefore constructed
indicators of socio-economic circumstances and health at 33 years from factors
already shown to be associated with health in later life. For the socio-economic 
indicator we used a combination of income, occupational status and home ownership
and described this as socio-economic capital. For the health indicator we
combined scores of body mass index, leisure time exercise, frequency of eating
fresh fruit and of smoking, and described this as health capital. After
controlling for pre-labour market socio-economic and health factors, prolonged
unemployment is shown here to reduce significantly both socio-economic and health
capital by age 33 years. We conclude that the experience of prolonged
unemployment early in the working life of this population of young men looks
likely to have a persisting effect on their future health and socio-economic
circumstances.

PMID: 10369448 [PubMed - indexed for MEDLINE]


97. Psychol Med. 1999 Mar;29(2):351-66.

Mild mental retardation: psychosocial functioning in adulthood.

Maughan B, Collishaw S, Pickles A.

MRC Child Psychiatry Unit and Social, Genetic and Developmental Psychiatry
Research Centre, Institute of Psychiatry, London.

BACKGROUND: Evidence on the adult adaptation of individuals with mild mental
retardation (MMR) is sparse, and knowledge of the factors associated with more
and less successful functioning in MMR samples yet more limited. METHOD:
Prospective data from the National Child Development Study were used to examine
social circumstances and psychosocial functioning in adulthood in individuals
with MMR and in a non-retarded comparison group. RESULTS: For many individuals
with MMR, living circumstances and social conditions in adulthood were poor and
potential stressors high. Self-reports of psychological distress in adulthood
were markedly elevated, but relative rates of psychiatric service use fell
between childhood and adulthood, as reflected in attributable risks. Childhood
family and social disadvantage accounted for some 20-30% of variations between
MMR and non-retarded samples on a range of adult outcomes. Early social adversity
also played a significant role in contributing to variations in functioning
within the MMR sample. CONCLUSIONS: MMR appears to be associated with substantial
continuing impairment for many individuals.

PMID: 10218926 [PubMed - indexed for MEDLINE]


98. Acta Psychiatr Scand. 1998 Dec;98(6):480-6.

Suicidal ideation among the long-term unemployed: a 5-year follow-up.

Claussen B.

Institute of General Practice and Community Medicine, Department of Social
Insurance Medicine, University of Oslo, Norway.

Suicidal ideation was monitored in a 5-year follow-up of a representative sample 
of long-term unemployed Norwegians. Four items from the General Health
Questionnaire-28 were used as a Suicidal Ideation Index, which showed a
prevalence of 17% in the present sample of unemployed subjects, higher than the
value of 11% in a sample of Australian students used to construct the Index. Five
years later, suicidal ideation was found in 6% of those who had been re-employed 
and 22% of those still unemployed, indicating that the high prevalence of
suicidal ideation may be due to unemployment. Routine clinical examination was
also tried for preventive purposes. In total, 8% of the unemployed subjects
showed clinically significant suicidal ideation. They were referred to a
psychologist or their GP, and were given the standard advice about suicide
prevention. A Resource Centre, which many employees at the Labour Office have
missed, has now been set up in the area under the National Plan for Suicide
Prevention.

PMID: 9879791 [PubMed - indexed for MEDLINE]


99. Am J Prev Med. 1998 Nov;15(4):344-61.

Worksite physical activity interventions.

Dishman RK, Oldenburg B, O'Neal H, Shephard RJ.

Department of Exercise Science, University of Georgia, Athens 30602-6554, USA.

BACKGROUND: National objectives for public health have targeted worksite as
important settings for interventions to increase physical activity. However,
expert reviews reveal no scientific consensus about the effectiveness of worksite
interventions for increasing physical activity or fitness. METHODS: We judged the
quantity and quality of existing evidence against scientific standards for the
internal and external validity of the research design and the validity of
measurements. Meta-analytic methods were used to quantify the size of effects
expressed as Pearson correlation coefficients (r). Variation in effect was
examined in relation to several features of the studies deemed important for
implementing successful worksite interventions. Pre-experimental cohort studies
were excluded because they are sensitive to secular trends in physical activity. 
RESULTS: Twenty-six studies involving nearly 9,000 subjects yielded 45 effects.
The mean effect was heterogeneous and small, r = 0.11 (95% CI, -0.20 to 0.40),
approximating 1/4 S.D., or an increase in binomial success rate from 50% to 56%. 
Although effects varied slightly according to some of the study features we
examined, effects were heterogeneous within levels of these features. Hence, the 
moderating variables examined did not explain variation in the effects (P >
0.05). The exception was that effects were smaller in randomized studies compared
with studies using quasi-experimental designs (P < 0.05). CONCLUSIONS: Our
results indicate that the typical worksite intervention has yet to demonstrate a 
statistically significant increase in physical activity or fitness. The few
studies that have used an exemplary sample, research design, and outcome measure 
have also yielded small or no effects. The generally poor scientific quality of
the literature on this topic precludes the judgment that interventions at
worksites cannot increase physical activity or fitness, but such an increase
remains to be demonstrated by studies using valid research designs and measures.

PMID: 9838977 [PubMed - indexed for MEDLINE]


100. J Stud Alcohol. 1998 Nov;59(6):669-80.

Underemployment and alcohol misuse in the National Longitudinal Survey of Youth.

Dooley D, Prause J.

Department of Psychology and Social Behavior, University of California, Irvine
92697, USA.

OBJECTIVE: This study measured the impact of unemployment and underemployment on 
alcohol misuse. METHOD: A panel of respondents from the National Longitudinal
Survey of Youth was studied in 1984-85 and 1988-89. In each pair of years, the
effect of employment change (e.g., becoming underemployed) on alcohol misuse was 
assessed controlling for misuse in the first year. Alcohol misuse was
operationalized in two ways: elevated symptoms and heavy drinking. Three samples 
were analyzed: a core sample of 2,441 who were available in both pairs of years
(approximately 65% male) and two extended samples that included everyone
available in one pair of years but not the other (n = 4,183 in 1984-85 and n =
3,926 in 1988-89). RESULTS: The 1984-85 analyses revealed a significant
association of adverse change in employment with both elevated alcohol symptoms
and heavy drinking (the latter moderated by prior heavy drinking). The 1988-89
analyses found no relationship between adverse change in employment and heavy
drinking in the core sample and no main effect of adverse change in employment on
symptoms, but they did reveal interactions involving prior symptoms (core sample)
and marital status (extended sample). CONCLUSIONS: Several explanations for these
decreasing effects over time were considered including changes in measurement
reliability, statistical power, economic environment and respondents' maturity.
These results confirm previous findings that job loss can increase the risk of
alcohol misuse, provide new evidence that two types of underemployment
(involuntary part-time and poverty-level wage) can also increase this risk and
suggest that these effects vary over time.

PMID: 9811088 [PubMed - indexed for MEDLINE]


101. Occup Med (Lond). 1998 May;48(4):219-25.

Health and employment after a diagnosis of occupational asthma: a descriptive
study.

Ross DJ, McDonald JC.

Department of Occupational and Environmental Medicine, National Heart and Lung
Institute, Imperial College, London, UK. david.ross@ic.ac.uk

The objectives of this study were to describe changes in asthma and employment
after diagnoses of occupational asthma reported to the SWORD project.
Questionnaires were sent to 312 physicians for all 1,940 cases of occupational
asthma reported from 1989-92; 1,769 (91%) were returned but information was
available for only 1,317 (68%). Of patients reported by occupational physicians, 
45% had recovered from asthma compared to only 14% of those reported by chest
physicians (excluding medicolegal cases), presumably because of differences in
severity. Proportions with the same employer were 49% and 48% respectively.
Patients exposed for a year or more after diagnosis recovered from asthma less
frequently but were more often employed than those exposed for less than a year. 
Among those whose asthma was attributed to high molecular weight agents, smokers 
had developed asthma earlier after exposure began than others but had the best
prognosis. Asthma developed following a single high exposure in 18 cases (2%), of
which 13 were to irritants and five to known sensitizers.

PMID: 9800419 [PubMed - indexed for MEDLINE]


102. J Health Soc Behav. 1998 Sep;39(3):216-36.

Interacting effects of multiple roles on women's health.

Waldron I, Weiss CC, Hughes ME.

Department of Biology, University of Pennsylvania, Philadelphia, PA 19104-6018,
USA. iwaldron@sas.upenn.edu

Our study tests several hypotheses concerning the effects of employment,
marriage, and motherhood on women's general physical health. These hypotheses
predict how the health effect of each role varies, depending on specific role
characteristics and the other roles a woman holds. Our analyses utilize
longitudinal panel data for 3,331 women from the National Longitudinal Surveys of
Young Women (follow-up intervals: 1978-83 and 1983-88). The Role Substitution
Hypothesis proposes that employment and marriage provide similar resources (e.g.,
income and social support), and consequently, employment and marriage can
substitute for each other in their beneficial effects on health. As predicted, we
found that employment had beneficial effects on health for unmarried women, but
little or no effect for married women. Similarly, marriage had beneficial effects
on health only for women who were not employed. The Role Combination Strain
Hypothesis proposes that employed mothers experience role strain, resulting in
harmful effects on health. However, we found very little evidence that the
combination of employment and motherhood resulted in harmful health effects.
Contrary to the predictions of the Quantitative Demands Role Strain Hypothesis,
it appears that neither longer hours of employment nor having more children
resulted in harmful effects on health. As predicted by the Age-Related Parental
Role Strain Hypothesis, younger age at first birth, particularly a teenage birth,
appeared to result in more harmful health effects.

PMID: 9785695 [PubMed - indexed for MEDLINE]


103. East Afr Med J. 1998 Jan;75(1):41-6.

Socio-demographic characteristics of family planning clients and their possible
influence on contraception in Malawi.

Lema VM, Mtimavalye LA, Msiska FS.

Department of Obstetrics and Gynaecology, College of Medicine, University of
Malawi, Blantyre, Malawi.

In a survey of family planning clients at the central Teaching Hospital,
Blantyre, between July 1 and December 31, 1993, to determine their social,
biological and reproductive profiles, contraceptive awareness and previous use,
766 new clients were recruited and interviewed by means of partially structured
questionnaire. Their mean age was 27 years, with a range of 15-43 years.
Adolescents formed 10.1% and those above 35 years of age were 17.1%. 91.3% were
married. While 12.6% had no formal education, 29.7% had secondary school
education and higher. Their mean parity and living children were 3.6 and 3.1
respectively. The mean desired fertility was 4.5. 93.3% of all clients had live
births in their last pregnancies. Contraceptive awareness was quite high, about
98.0%. However, only 30.9% had ever-used contraceptives before then. When these
are looked at against a background of the corresponding situations in the
country, it appears that the individuals seeking, accepting and using
contraceptives in Malawi, are better off in the various aspects of life, thus
suggesting their possible influence on contraceptive use. There is need to review
the national family planning programme, address the contraceptive needs of
adolescents and women aged above 35 years, improve formal female education,
change the prevailing socio-cultural and traditional beliefs and practices which 
affect women adversely, thus empowering them over affairs of their health.

PIP: This study examined the social, demographic, and reproductive profiles and
contraceptive usage of women seeking contraceptive services at the largest public
clinic in Blantyre, Malawi, during July 1 to December 31, 1993. Data were
obtained from a prospective survey among 830 new family planning clients at the
Queen Elizabeth Central Teaching Hospital. 69.1% of new clients were seeking
contraception for the first time. The mean age of new clients was 27 years. 10.1%
of new clients were aged 10-19 years, and 17.1% were aged over 35 years. Almost
30% had a secondary education or higher. 57.7% had only primary school education.
12.6% had no formal education. Better educated women had lower parity, number of 
living children, and desired fertility. 91.3% were married. 66.3% were
housewives. 24.4% were engaged in formal employment. 88.5% of male partners were 
engaged in formal employment. The mean age at menarche was 15 years. The mean
parity was 3.6. Nearly 60% of women aged under 24 years had a parity of 2 or
higher. 65.9% had the same number of living children as their parity. 31.1% of
women desired 4 children. 13.4% desired a pregnancy within 2 years of the
previous pregnancy, which was a poor outcome. Women with a higher number of
living children had the desire for the longest birth interval. 98.7% knew at
least one family planning method. 30.9% had ever used contraceptives (oral pills 
and condoms). 49.0% and 42.9% of the 963 clients accepted, respectively, the oral
pill and Depo Provera. There was a strong correlation between the methods known
and desired, and the methods accepted.

PMID: 9604534 [PubMed - indexed for MEDLINE]


104. Spine (Phila Pa 1976). 1998 Jan 15;23(2):235-43.

Determinants of self-reported neck-shoulder and low back symptoms in a general
population.

Barnekow-Bergkvist M, Hedberg GE, Janlert U, Jansson E.

Department of Physiology and Technology, National Institute for Working Life,
Umeå, Sweden.

STUDY DESIGN: A combined cross-sectional and longitudinal design. OBJECTIVES: To 
investigate relation between, on one hand, self-reported neck-shoulder symptoms
and, on the other hand, low back symptoms and self-reported work-related physical
load, psychosocial factors, and individual characteristics and to study the
influence of physical capacity in adolescence on neck-shoulder and low back
symptoms in adulthood. SUMMARY OF BACKGROUND DATA: Heavy physical work and
exposure to vibration constitute risk factors for low back problems, and
repetitive and static work are risk factors for neck-shoulder symptoms in many
jobs. The interplay between individual factors and work-related psychosocial and 
physical exposure, however, is not well documented. This study addresses effects 
of adolescent capacity on this interplay in a general population. METHODS: A
random sample of 425 Swedish students was investigated when the students were 16 
years and 34 years of age. Sixty-five percent participated in both examinations; 
only those who worked > or = 16 hours/week at the follow-up period, 148 men and
90 women, were included in these analyses. Data about musculoskeletal symptoms,
work, and sociodemographic and individual characteristics were collected at the
age of 34 years; physical performance data were collected at the ages of 16 years
and 34 years. RESULTS: Among the men, self-employment and worry were associated
with neck-shoulder symptoms; among the women, monotonous work and high decision
latitude were associated with neck-shoulder symptoms. Low back problems were
related to monotonous work among men and women and to exposure to vibration among
men. Performance in certain fitness tests at the ages of 16 years and 34 years
was negatively associated with musculoskeletal symptoms. CONCLUSIONS: The inverse
relationships between performance at the age of 16 years and adult
musculoskeletal symptoms may imply benefits of early fitness training.

PMID: 9474732 [PubMed - indexed for MEDLINE]


105. Future Child. 1997 Spring;7(1):122-7.

Low-wage maternal employment and outcomes for children: a study.

Moore KA, Driscoll AK.

Child Trends, Inc., Washington, DC, USA.

Comment on:
    Future Child. 1997 Spring;7(1):110-5.

Despite the importance of anticipating how children may be affected by policies
that move mothers off welfare and into employment, as the article by Zaslow and
Emig in this journal issue points out, few research studies have addressed this
critical policy question. To help fill that gap, this article presents the
results of a new study using national survey data to examine child outcomes among
families that had previously received welfare. About half the families studied
had mothers who remained at home, the others were working at varying wage levels.
The findings reported here echo themes discussed in the two preceding articles.
Maternal employment does not appear to undermine children's social or cognitive
development from ages 5 to 14, and it may yield advantages. Children whose
mothers earned more than $5.00 per hour, particularly, had somewhat better
outcomes than others. The authors emphasize, however, that background
characteristics specific to the mothers who chose employment contributed to these
positive outcomes. The authors add that it would be risky to apply these
generalizations based on these findings to families forced into employment by
welfare reform.

PMID: 9170739 [PubMed - indexed for MEDLINE]


106. Soc Biol. 1996 Fall-Winter;43(3-4):191-202.

Trends in the relationship between breastfeeding and postpartum employment in the
United States.

Lindberg L.

Urban Institute, Washington, DC 20037, USA.

It is widely assumed that employment and breastfeeding are relatively
incompatible behaviors in the United States; yet recently both the incidence of
breastfeeding and the incidence of postpartum employment increased. This paper
examines the relationship between these trends from 1968-86 using data from the
National Surveys of Family Growth. I find that these trends result from increases
in the likelihood that a woman engages in both breastfeeding and postpartum
employment. There has been an increase over time in the incidence and duration of
women concurrently breastfeeding and working. However, the majority of employed
women did not concurrently breastfeed, suggesting that conflicts between these
behaviors still exist.

PMID: 9204696 [PubMed - indexed for MEDLINE]


107. Alcohol Clin Exp Res. 1996 Apr;20(2):372-8.

Toward an alcohol treatment model: a comparison of treated and untreated
respondents with DSM-IV alcohol use disorders in the general population.

Grant BF.

Division of Biometry and Epidemiology, National Institute on Alcohol Abuse and
Alcoholism, Bethesda, Maryland 20892-7003, USA.

The purpose of this study was to compare characteristics of person with alcohol
use disorders who sought alcohol treatment with those who did not using data from
a nationally representative sample of the United States. Applying an organizing
framework from the larger literature on service utilization, a logistic
regression analysis was conducted to examine the interaction among factors
influencing treatment. The results identified unemployment status and lower
educational level as barriers to alcohol treatment, but the impact of these
factors differed depending on whether the respondent had previous experience with
alcohol treatment. The major findings of this study are discussed in terms of
consumer satisfaction, minimizing barriers to alcohol treatment services, and the
need to examine individual determinants of alcohol treatment within the larger
context of organizational and sociopolitical factors.

PMID: 8730232 [PubMed - indexed for MEDLINE]


108. Compr Psychiatry. 1996 Mar-Apr;37(2):115-21.

A cluster analytic study of functional outcome after psychiatric hospitalization.

Goethe JW, Dornelas EA, Fischer EH.

Institute of Living, Hartford, CT 06106, USA.

We report the initial results from a prospective study designed to assess
patients' functional outcome and level of service utilization following
psychiatric hospitalization. All patients admitted between March 31, 1993 and
April 1, 1994 were interviewed at admission and discharge, and 350 consenting
patients were reassessed 3 months postdischarge. Subgroups were created using
cluster analysis (measures of outcome were rehospitalization, self-rated
productivity and functioning, and satisfaction with living situation and
employment/daily activities at the 3-month follow-up study), and these clusters
were then validated using other variables. Four distinct outcome categories were 
identified. Cluster I contained patients with the greatest functional impairment 
and the highest rate of rehospitalization (28%). Cluster IV patients reported
superior functioning and satisfaction and the lowest rate of rehospitalization
(8%). Clusters II and III had intermediate outcomes, the first characterized by
greater satisfaction with living situation, and the other by higher ratings for
functioning and productivity. Outcome data are important to providers for program
evaluation and patient care; if replicated in other samples, the four outcome
categories reported may be useful for national mental health care policy and
planning.

PMID: 8654060 [PubMed - indexed for MEDLINE]


109. Bull N Y Acad Med. 1996 Winter;73(2):370-97.

Occupations, cigarette smoking, and lung cancer in the epidemiological follow-up 
to the NHANES I and the California Occupational Mortality Study.

Leigh JP.

Department of Economics, San Jose State University, CA 95192-0114, USA.

What jobs are associated with the highest and lowest levels of cigarette use and 
of lung cancer? Are there gender differences in these jobs? Two data sets-the
Epidemiological Follow-up to the National Health and Nutrition Examination Survey
(NHEFS) and the California Occupational Mortality Study (COMS) were analyzed to
answer these questions. For females, the broad occupations ranking from highest
to lowest cigarette use in the NHEFS was: transportation operators, managers,
craft workers, service workers, operatives, laborers, technicians, administrative
workers, farm owners and workers, sales workers, no occupation, and
professionals. The corresponding ranking for males was: transportation operators,
no occupation, laborers, craft workers, service workers, technicians, and
professionals. The highest-ranking jobs in the COMS were waitresses, telephone
operators, and cosmetologists for women, and water-transportation workers,
roofers, foresters and loggers for men. Teachers were especially low on all four 
lists. This study could not determine whether employment within any occupation
encouraged smoking or if smokers selected certain occupations.

PMCID: PMC2359318
PMID: 8982527 [PubMed - indexed for MEDLINE]


110. Scand J Work Environ Health. 1995 Dec;21(6):427-34.

Musculoskeletal symptoms among sewing machine operators.

Schibye B, Skov T, Ekner D, Christiansen JU, Sjøgaard G.

National Institute of Occupational Health, Copenhagen, Denmark.

OBJECTIVES: A longitudinal study was conducted to describe the prevalences and
development of musculoskeletal symptoms among sewing machine operators in
relation to age and exposure and among former sewing machine operators who
changed exposure by changing occupation. METHODS: Musculoskeletal symptoms were
assessed among 327 sewing machine operators in 1985 with the use of the
standardized Nordic questionnaire. A follow-up study in 1991 showed that
approximately one-third was still working as a sewing machine operator, one-third
had changed occupation, and the rest were out of employment. The exposure was
assessed by a questionnaire regarding the type of machine being operated, work
organization, workplace design, units produced per day, and payment system.
RESULTS: High prevalences of musculoskeletal symptoms of the neck and shoulders
were found, with some associations to exposure variables such as efficiency.
Initially symptom-free sewing machine operators were not at a higher risk of
developing symptoms when they continued sewing during the six-year follow-up when
compared with those who changed to other employment. However, symptomatic sewing 
machine operators who quit sewing were much more likely to be relieved of their
symptoms than were symptomatic operators who continued sewing, odds ratio 3.26
[95% confidence interval (95% CI) 1.38-7.72] for 12-month symptoms and odds ratio
3.90 (95% CI 1.28-11.90) for 7-day symptoms. This trend also applied to
long-lasting symptoms. CONCLUSIONS: The results demonstrate that, for many sewing
machine operators, neck and shoulder symptoms are reversible and may be
influenced by reallocation to other worktasks.

PMID: 8824748 [PubMed - indexed for MEDLINE]


111. Occup Med (Lond). 1995 Oct;45(5):234-8.

Is a telephone helpline of value to the workplace smoker?

Amos A, White DA, Elton RA.

Department of Public Health Sciences, University of Edinburgh, UK.

This paper reports the findings of the evaluation of a national smokers' helpline
which was set up by British Telecom (BT) for its employees. The helpline formed
part of a new comprehensive smoking policy for all BT staff. Over 1000 employees,
more than 3.0% of all smokers, phoned the helpline during the first three months 
of its operation. Two-thirds of callers tried to quit smoking after calling the
helpline, and a quarter were still successful three months later. One in six
callers reduced the number of cigarettes that they smoked on working days. While 
the helpline and other cessation support services were evaluated positively by
callers, it appears that helplines only appeal to a small minority of smokers.
However, they do seem to be an effective mechanism for a nationwide company to
identify those smokers who want support, and a useful means of centralizing the
administration of support services. They are potentially a cost-effective option 
for larger employers.

PMID: 7579297 [PubMed - indexed for MEDLINE]


112. Eur Respir J. 1995 Sep;8(9):1514-9.

Allergic sensitization is associated with increased bronchial responsiveness: a
prospective study of allergy to laboratory animals.

Renström A, Malmberg P, Larsson K, Larsson PH, Sundblad BM.

National Institute of Occupational Health, Sweden.

The purpose of this prospective study was to investigate the extent of change in 
bronchial responsiveness and the prognostic value of methacholine provocation in 
early sensitization to laboratory animals. Thirty eight laboratory technicians
were studied during training (before first exposure) and after having been
exposed to laboratory animals for a median 18 (range 5-33) months. On both
occasions they were subjected to spirometry, bronchial methacholine challenge,
skin-prick tests and blood sampling, and responded to questionnaires. Nine (24%) 
developed laboratory animal allergy (LAA), defined as animal work-related
symptoms (n = 8), or specific immunoglobulin E (IgE) (n = 7) or both. In the LAA 
group, bronchial responsiveness was normal before employment, but had increased
significantly at follow-up compared to technicians who had not developed LAA. Six
of the nine LAA subjects had a more than threefold increase in bronchial
responsiveness, and three of these reported chest symptoms. Spirometric values
were not different between the groups prior to exposure or at follow-up, and had 
no prognostic value. However, a pre-employment level of total IgE > 100 kU.L-1
predicted the development of LAA (relative risk 2.8). Thus, early LAA was
associated with increased bronchial responsiveness in most subjects. In contrast 
to total IgE, the level of pre-employment bronchial responsiveness or lung
function did not influence the magnitude of change in responsiveness, nor predict
sensitization.

PMID: 8575577 [PubMed - indexed for MEDLINE]


113. Am J Ind Med. 1995 Jun;27(6):793-805.

A detailed analysis of work-related injury among youth treated in emergency
departments.

Knight EB, Castillo DN, Layne LA.

Division of Safety Research, National Institute for Occupational Safety and
Health, Morgantown, West Virginia 26505, USA.

Telephone interviews were conducted with 146 14- to 16-year-olds who incurred an 
occupational injury treated in an emergency department during the period July
through September 1992. Thirty-two percent of the injuries occurred as the result
of using equipment. Over half the workers reported not having received prior
training on how to avoid injury. The injury limited normal activities for at
least 1 day for 68% of the youth and for more than a week for 25%, corresponding 
to an estimated 6,208 (95% CI: 4,277, 8,139) and 2,639 (95% CI: 1,580, 3,699)
youths nationwide, respectively. Employment in retail trades, equipment use, lack
of training, and burn injuries were associated with increased limitation of
normal activities. Nineteen percent of the youths appear to have been injured in 
jobs declared to be hazardous, or typically prohibited for their age (14- and
15-year-olds) under federal child labor laws. The prohibited job directly
contributed to the injury in 64% of these cases.

PMID: 7645574 [PubMed - indexed for MEDLINE]


114. Med Pediatr Oncol. 1995 Mar;24(3):160-5.

Survival after retinoblastoma: long-term consequences and family history of
cancer.

Byrne J, Fears TR, Whitney C, Parry DM.

Epidemiology and Biostatistics Program of the National Cancer Institute, National
Institutes of Health, Bethesda, Maryland.

Retinoblastoma (Rb) is a rare childhood tumor of the eye. In the heritable form, 
tumors are often bilateral and survivors have a greatly increased risk both for a
second malignancy and for having children with Rb. Familial patterns of both
cancer and birth defects are poorly understood in families with a heritable
cancer, and little is known of the ways that a heritable cancer affects the lives
of long-term survivors. To find out more about these and other issues in the
lives of long-term survivors of childhood and adolescent cancer, we interviewed
56 adult survivors of retinoblastoma (15 with the heritable form) and 84 brothers
and sisters as controls, who formed part of a large retrospective cohort study.
Rb survivors were interviewed between 1980 and 1983, when they were 30 years old 
on average. Types of employment and health problems did not differ between
survivors and controls, regardless of sight, but the income of blind survivors
was considerably less than that of partially sighted survivors. Despite similar
marriage rates, fewer survivors than controls reported a pregnancy (RR = 0.45;
95% CI; 0.24-0.83 for both sexes combined). Parents of children with heritable Rb
seemed more likely to have had cancer than parents in families with nonheritable 
Rb (P = 0.06), and mothers were more likely than fathers to be affected (P =
0.01). This small series suggests that having retinoblastoma may have many
long-term consequences, reaching beyond genetic and physical effects to touch
family life and income attainment and the health of other family members.
Follow-up of more modern cohorts and the use of molecular tools will clarify the 
long-term consequences of more recent therapies, and patterns of familiar cancer.

PMID: 7838037 [PubMed - indexed for MEDLINE]


115. Stroke. 1994 Jul;25(7):1360-5.

Prognosis of young adults with ischemic stroke. A long-term follow-up study
assessing recurrent vascular events and functional outcome in the Iowa Registry
of Stroke in Young Adults.

Kappelle LJ, Adams HP Jr, Heffner ML, Torner JC, Gomez F, Biller J.

University Department of Neurology, University Hospital Utrecht, The Netherlands.

BACKGROUND AND PURPOSE: Information about the long-term prognosis of young adults
with ischemic stroke is limited. Therefore, we performed a follow-up assessment
of 296 patients with ischemic stroke who are enrolled in the Iowa Registry of
Stroke in Young Adults. We studied young adults (age, 15 to 45 years) who were
referred to a tertiary medical center for management of ischemic stroke between
July 1, 1977, and January 1, 1992. METHODS: Follow-up assessments were performed 
by means of questionnaires, examinations, telephone interviews, review of medical
records, and reports from personal physicians. Data about risk factors,
coincident medical diseases, etiology of stroke, treatment, recurrent stroke,
other vascular events, and deaths were collected. Outcomes were rated with the
Glasgow Outcome Scale, Barthel Index, National Institutes of Health stroke scale,
and the Mini-Mental State Examination. Quality of life was assessed with the
SF-36 Health Status questionnaire. RESULTS: Follow-up information about the
status of 10 patients was limited except that they were alive. Twenty-one
patients (7%) died as the result of their initial stroke, and another 40 patients
(14%) died during a mean follow-up of 6.0 years. None of the patients aged 25
years or younger at the time of stroke died during follow-up. Mortality was
significantly higher among patients who had a stroke secondary to large-vessel
stroke and it was significantly lower in patients with stroke of unknown etiology
than in patients with stroke of other causes (relative risk [RR], 1.7; 95%
confidence limits [CL], 1.0 to 2.7; and RR, 0.1; CL, 0 to 0.6; respectively).
Recurrent strokes occurred in 23 patients (9%) and were fatal in 9. Another 37
patients were treated by a cardiologist during follow-up; 3 had had a myocardial 
infarct. Fourteen additional patients needed major vascular surgery. Outcomes
with the Glasgow Outcome Scale and Barthel Index were generally favorable. Still,
only 49% of patients were still alive, were not disabled, had not suffered from
recurrent vascular events, or had not undergone major vascular surgery. Only 42% 
of survivors had returned to work. A majority of survivors reported emotional,
social, or physical residuals that lessened the quality of life. CONCLUSIONS: The
risks of recurrent vascular events in young adults who have had ischemic stroke
are considerable. In addition, a majority of survivors will have residual
emotional, social, or physical impairments that hamper employment or lower the
quality of life. Further research on the quality of life for young adults who
survive stroke is needed.

PMID: 8023350 [PubMed - indexed for MEDLINE]


116. Scand J Prim Health Care. 1993 Dec;11(4):234-40.

A clinical follow up of unemployed. II: Sociomedical evaluations as predictors of
re-employment.

Claussen B.

National Institute of Public Health, Unit for Health Services Research, Oslo,
Norway.

OBJECTIVE--To frame and study sociomedical evaluations in clinical work with
unemployed people. DESIGN--In a two-year follow up of routine health
examinations, three sociomedical evaluations were set up. The first was the
direct conclusion of the check-up, based on sickness and possibilities of
treatment. The second dealt with work identity, and the last was a diagnostic set
of main unemployment problem. SETTING--The four municipalities of Grenland,
Norway. PARTICIPANTS--A representative sample aged 16 to 63 who had been
registered with the labour market authorities for more than 12 weeks.
RESULTS--21% of the unemployed needed further treatment. 7% were classified as
"discouraged", being on their way out of the labour market, while the majority of
the study group was healthy job seekers. Work identity seemed to be wage earning 
for 83%, homemaking for 9%, cultural work for 3%, and being a pensioner for 5%.
The main unemployment problem was lack of work for 46% of the examined. Other
problems were poor health, being less attractive workers, or having little
courage for job search. The evaluations predicted re-employment after two years. 
They divided the unemployed in groups with from five to seven times difference in
re-employment rate. CONCLUSION--These standardized sociomedical evaluations seen 
to be useful in clinical work with unemployed people.

PMID: 8146506 [PubMed - indexed for MEDLINE]


117. Scand J Prim Health Care. 1993 Sep;11(3):211-8.

A clinical follow up of unemployed. I: Lifestyle, diagnoses, treatment and
re-employment.

Claussen B.

National Institute of Public Health, Unit for Health Services Research, Oslo,
Norway.

OBJECTIVE--To describe morbidity, lifestyle and re-employment in a representative
sample of unemployed people. DESIGN--A two-year follow up of a routine health
examination consisting of a structured interview, a clinical examination and the 
doctor's conclusions and advice. SETTING--Four municipalities in Greenland,
southern Norway. PARTICIPANTS--A representative sample aged 16 to 63 who had been
registered with the labour market authorities for more than 12 weeks.
RESULTS--Self-reported diseases were more common in the study group than were
found in employed people, especially musculoskeletal and mental disorders. The
prevalence of medical diagnoses was high. Smoking was reported by nearly twice as
many unemployed as the reference population. Heavy alcohol consumption was more
prevalent in the unemployed men. Blood pressure was lower than in the reference
population. Cholesterol was higher in the unemployed women. Many needed
counselling or referrals. Having a medical diagnosis reduced the chances of
re-employment two years later. Thus, health-related selection for re-employment
seems to explain some of the excess morbidity among unemployed people.
CONCLUSION--The long-term unemployed is a group with high morbidity and unhealthy
lifestyle. General practitioners should be aware of this pattern in clinical and 
preventive work.

PMID: 8272655 [PubMed - indexed for MEDLINE]


118. Paediatr Perinat Epidemiol. 1993 Jul;7(3):318-33.

First report from the Plunket National Child Health Study: smoking during
pregnancy in New Zealand.

Alison LH, Counsell AM, Geddis DC, Sanders DM.

Royal New Zealand Plunket Society, Dunedin.

The Plunket National Child Health Study is a 5-year longitudinal study of a birth
cohort of 4285 children born in New Zealand during 1990-1991. This paper
describes the major lines of epidemiological research, the methods and study
design, and reports on the demographic data of New Zealand children. During this 
first report from the Plunket Child Health Study, we examine on the smoking rates
of New Zealand mothers during pregnancy. Overall 33% of mothers smoked during
pregnancy. Particularly high rates were found amongst teenage mothers,. Maori
women, single women and women with lower educational levels. Over 60% of women in
these categories smoked during pregnancy.

PMID: 8378172 [PubMed - indexed for MEDLINE]


119. Br J Ind Med. 1993 May;50(5):450-9.

Mortality and incidence of cancer in a cohort of Swedish chimney sweeps: an
extended follow up study.

Evanoff BA, Gustavsson P, Hogstedt C.

Division of Occupational Medicine, National Institute of Occupational Health,
Solna, Sweden.

Despite 200 years of efforts to regulate safety in this occupation, chimney
sweeps have increased mortality from cancer, ischaemic heart disease, and
respiratory disease. Mortality and incidence of cancer were examined in a cohort 
of 5542 Swedish chimney sweeps employed through their national trade union at any
time between 1918 and 1980. Previous studies of this cohort found increased risks
of ischaemic heart disease, respiratory disease, accidental deaths, and various
neoplasms. By increasing follow up, we sought to increase the power of the study 
and examine disease time trends. Mortality analysis was extended 7.5 years to
cover the period 1951-90; cancer incidence analysis was extended six years to
cover the period 1958-87. New findings include increased incidence and mortality 
of prostate cancer (SMR 169, 95% CI 106-256, 22 observed) and increased incidence
of total haematolymphatic cancers (SIR 151, 95% CI 106-209, 36 observed). When
only the most recent follow up period was analysed, previously observed risks
persisted for total lung cancer (SIR 178, 95% CI 99-293), oat cell lung cancer
(SIR 240, 95% CI 103-472), bladder cancer (SIR 247, 95% CI 131-422), and
oesophageal cancer (Obs/Exp = 2/1.1). Mortality from ischaemic heart disease (SMR
98, 95% CI 76-123) and respiratory disease (SMR 111, 95% CI 56-199) declined
during recent follow up, although significant excess mortality remained during
analysis of the entire study period (ischaemic heart disease SMR 128, 95% CI
112-145; respiratory disease SMR 159, 95% CI 115-213). In analyses of the entire 
study period, risks of ischaemic heart disease and lung, bladder, and oesophageal
cancer were adjusted for smoking; oesophageal cancer was also adjusted for use of
alcohol. All risks remained significantly raised. Exposure-response analyses
showed significant positive associations between duration of employment and risks
for mortality from lung, oesophageal, and total cancer. Chimney sweeps remain at 
increased risk for cancers of the lung, oesophagus, and bladder. Our study
supports a casual role for exposure to chimney soot, which contains carcinogens
including polycyclic aromatic hydrocarbons. Extended follow up of this cohort now
shows increased risks of prostate and haematolymphatic cancers.

PMCID: PMC1012164
PMID: 8507598 [PubMed - indexed for MEDLINE]


120. Addiction. 1993 Mar;88(3):363-8.

The Alcohol Use Disorders Identification Test (AUDIT) in a routine health
examination of long-term unemployed.

Claussen B, Aasland OG.

National Institute of Public Health, Unit for Health Services Research, Oslo,
Norway.

A representative sample of 310 long-term unemployed in Norway was followed for 2 
years with clinical examinations and the AUDIT questionnaire. 30% of the men and 
8% of the women scored over the cut-off point for an alcohol use disorder. This
gives a probable prevalence of 16%. The test predicted return to employment in
this sample. The AUDIT answers were also used as a basis for dividing into three 
groups: 'normal', 'hazardous' and 'harmful'. At 2 year follow-up, 27% had changed
group, 32 respondents to the worse and 24 to the better. This 'unstable' group
was characterized by weaker social network and more frequent drinking. The AUDIT 
was judged as a useful instrument both in a routine health examination and as an 
epidemiological tool.

PMID: 8461853 [PubMed - indexed for MEDLINE]


121. Int J Health Serv. 1993;23(4):743-61.

Health, physical activity level, and employment status in Canada.

Grayson JP.

Institute for Social Research, York University, North York, Ontario, Canada.

Over the past few years, research from several countries has demonstrated an
association between unemployment and poor health. In addition, a number of
studies have established a link between physical activity level and health. As
yet, however, there has been no comparison of the physical activity levels of the
employed and the unemployed in a national population and of the extent to which
the health of the employed and unemployed varies with physical activity levels.
The research presented in this article demonstrates that in Canada, while the
unemployed report comparable levels of physical activity to the employed, for all
levels of physical activity, they are less healthy than the employed, even after 
adjustments are made for age, gender and adequacy of family income. The effects
of unemployment on health, however, vary by duration of employment. Overall, the 
findings suggest that some benefits of elevated levels of physical activity are
dampened by the consequences of unemployment.

PMID: 8276533 [PubMed - indexed for MEDLINE]


122. Epidemiology. 1992 Nov;3(6):483-9.

Renal cell cancer among paperboard printing workers.

Sinks T, Lushniak B, Haussler BJ, Sniezek J, Deng JF, Roper P, Dill P, Coates R.

National Institute for Occupational Safety and Health, Cincinnati, OH.

A physician's alert prompted us to investigate workers' cancer risk at a
paperboard printing manufacturer. We conducted a retrospective cohort mortality
study of all 2,050 persons who had worked at the facility for more than 1 day,
calculated standardized incidence ratios (SIRs) for bladder and renal cell
cancer, and conducted a nested case-control study for renal cell cancer.
Standardized mortality ratios (SMRs) from all causes [SMR = 1.0, 95% confidence
interval (CI) = 0.9-1.2] and all cancers (SMR = 0.6, 95% CI = 0.3-1.0) were not
greater than expected. One bladder cancer and one renal cell cancer were included
in the mortality analysis. Six incident renal cell cancers were observed,
however, compared with less than two renal cell cancers expected (SIR = 3.7, 95% 
CI = 1.4-8.1). Based on a nested case-control analysis, the risk of renal cell
cancer was associated with overall length of employment but was not limited to
any single department or work process. Although pigments containing congeners of 
dichlorobenzidine and o-toluidine had been used at the plant, environmental
sampling could not confirm any current exposure. Several limitations and a
potential selection bias limit the inferences that can be drawn.

PMID: 1420513 [PubMed - indexed for MEDLINE]


123. Br J Addict. 1992 Jun;87(6):883-90.

A comparison of predictors of treatment drop-out of women seeking drug and
alcohol treatment in a specialist women's and two traditional mixed-sex treatment
services.

Copeland J, Hall W.

National Drug and Alcohol Research Centre, University of New South Wales,
Kensington, Australia.

The problem of high levels of client drop-out in drug and alcohol treatment is
frequently reported in the literature. In the course of conducting an evaluation 
of a specialist women's treatment service, the inadequacy of the data on
women-specific predictors of treatment drop-out was highlighted. Using a
retrospective design, the characteristics of 160 women who left treatment less
than 5 days after admission were compared to the 160 women who stayed longer than
5 days and were enrolled in the evaluation study. The findings of this study
suggested that women who were employed, had a history of sexual assault
(especially in adulthood), nominated alcohol as their drug of choice, were not
married, older than 25 years of age and had demonstrated a sympathy with the
agency's treatment philosophy were less likely to drop-out of treatment. In
addition, for lesbian women, women with a history of sexual assault in childhood,
and those with dependent children, attendance at a specialist women's service
reduced the incidence of treatment drop-out.

PMID: 1326359 [PubMed - indexed for MEDLINE]


124. Tidsskr Nor Laegeforen. 1992 Jan 20;112(2):218-21.

[Unemployment among long-term sick-listed persons. From the project Evaluation of
Follow-up of Long-term Sick-listed Persons]

[Article in Norwegian]

Berg JE, Tellnes G.

Instituttgruppe for samfunnsmedisin, Universitetet i Oslo.

The aim of the study was to compare two subgroups of patients with long-term
sickness certificate, i.e. a group who were unemployed after eight weeks of
incapacity for work and a group who still had a paid job at the end of the eight 
weeks. 712 patients who received a medical certificate II after eight weeks of
incapacity for work in 1988 were followed up for another 12-15 months by means of
information collected as a routine at the local National Insurance Offices in
five municipalities in Norway. Of our total sample of patients, the sub-group of 
unemployed persons differed in a number of ways from the group who still had a
job. Among the unemployed the duration of sickness certificate was longer and
there were higher frequencies of mental disorders and diseases of the nervous
system/sense organs. Admission to hospital was less frequent, however, among the 
unemployed group than among the group who still had a job. The rate of
return-to-work observed after one year of sickness certificate was lower among
the unemployed.

PMID: 1566255 [PubMed - indexed for MEDLINE]


125. J Epidemiol Community Health. 1991 Jun;45(2):117-24.

Occupational mortality of women aged 15-59 years at death in England and Wales.

Moser KA, Goldblatt PO.

Social Statistics Research Unit, City University, London.

STUDY OBJECTIVE--The aim was to analyse occupational mortality differences among 
women using follow up data from a large nationally representative sample.
DESIGN--Occupational information was obtained from the 1971 census records of
women in the Longitudinal Study carried out by the Office of Population Censuses 
and Surveys (OPCS) and related to their subsequent mortality in the period
between the 1971 and 1981 censuses. SETTING--In the Longitudinal Study, census,
vital statistics, and other OPCS records are linked for a 1% sample of the
population of England and Wales. The women studied in this paper were drawn from 
the 513,071 persons in the 1971 census who were included in the Longitudinal
Study and whose entries were traced at the National Health Service Central
Register by 1977. PARTICIPANTS--The analysis was based on 77,081 women aged 15-59
years in the Longitudinal Study for whom occupational information was collected
in the 1971 census (99% of whom were in paid employment in the week before the
census). There were 1553 deaths among these women in the follow up period
analysed here. MEASUREMENTS AND MAIN RESULTS--Numbers of deaths in each
occupational group at census were compared to those expected on the basis of age 
specific death rates among all women in the study. "Professional, technical
workers, and artists" had significantly low mortality while "Engineering and
allied trades workers nec" had significantly high mortality. Among the latter,
cancer mortality of electrical production process workers was extremely high. A
number of other cause specific associations (which appear to confirm
proportionate Decennial Supplement analyses) were suggested by the data; examples
include high levels of mortality from ischaemic heart disease among cooks, lung
cancer and respiratory disease among charwomen and cleaners, and accidents,
poisonings, and violence among several groups of professional and technical
workers. CONCLUSIONS--By using prospective follow up from the census,
occupational differences in mortality can be identified among women in paid
employment. As follow up of this study continues, numbers of deaths available for
analysis will increase, allowing increasingly comprehensive analyses to be
undertaken.

PMCID: PMC1060728
PMID: 2072070 [PubMed - indexed for MEDLINE]


126. Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1450-6.

The effect of physical activity during pregnancy on preterm delivery and birth
weight.

Klebanoff MA, Shiono PH, Carey JC.

Division of Prevention Research, National Institute of Child Health and Human
Development, National Institutes of Health, Bethesda, MD 20892.

The relationship between physical activity during pregnancy, preterm birth, and
gestational age-adjusted birth weight was investigated prospectively in a cohort 
of 7101 women. This study is one of few to evaluate both employment- and
non-employment-related physical activity. Prolonged periods of standing were
associated with a modestly increased risk of preterm delivery (adjusted odds
ratio for greater than or equal to 8 hours/day of standing = 1.31). Heavy work or
exercise was not associated with preterm delivery (adjusted odds ratio for
greater than or equal to 4 hours per day of heavy work = 1.04). The proportion of
infants born preterm did not differ among women working in predominantly
standing, active, and sedentary occupations. Physical activity was not associated
with gestational age-adjusted birth weight after controlling for confounding
variables. These data suggest that unmeasured socioeconomic differences among
women reporting different levels of activity may account for previously described
associations between physical activity and pregnancy outcome. Most pregnant women
who report increased levels of physical activity are not at increased risk of
preterm delivery or reduced intrauterine growth. However, these data do not
address the role of activity restriction in the management of selected women at
high risk for adverse pregnancy outcome.

PMID: 2240086 [PubMed - indexed for MEDLINE]


127. Br J Educ Psychol. 1990 Jun;60 ( Pt 2):171-9.

Future lives of truants: family formation and health-related behaviour.

Hibbett A, Fogelman K.

Employment Department, London.

This paper examines early adult outcomes of truancy regarding family formation
and health-related behaviour, and is based on data collected in the National
Child Development Study, which surveyed all people in Great Britain born in the
week 3-9 March 1958, at birth, and at ages 7, 11, 16 and 23. Truants compared to 
non-truants were found to be relatively more likely to have experienced marital
breakdown by the age of 23. They had more children, and their age at the birth of
their first child was younger. Truants differed little from non-truants regarding
their drinking habits, but were more prone to being heavy smokers. They also
showed an increased likelihood of depression. Differences remained after
controlling for social background, prior educational attainment, school
attendance and qualifications obtained. The authors conclude that truancy appears
to be associated with subsequent marital and psychological problems in early
adulthood.

PMID: 2378807 [PubMed - indexed for MEDLINE]


128. Enfoques Aten Prim. 1990 Apr;5(1):3-10.

[From anthropometrical evaluation to the prediction of nutritional facts at
infancy]

[Article in Spanish]

Mardones-restat F, Jones G, Diaz M.

PIP: This study developed instruments to predict the unsatisfactory growth of
children in the context of social programs, (health, education, nutrition, social
work, food and employment) which measure the probability of malnutrition using
anthropometry. Variables used were biological and social (family incompetency). A
cohort of 822 breastfeeding infants were followed prospectively from prenatal
until 12 months of age in 5 primary health clinics in Santiago, Chile. Weight by 
age was the dependent variable, defined as "unsatisfactory growth" if it was
under the 20th percentile established by the World Health Organization. By 1
year, 32% of the study population was in this category, reflecting national
statistics; at 3 months 8% of the infant population and no more than 2% of those 
breastfeeding were under the 20th percentile. 25 high risk variables were
selected that also demonstrated a high correlation with weight and age and these 
were evaluated by using 3 statistical methods: 1) the relative simple risk (RRS) 
used by the WHO; 2) logistical regression; and 3) classification and regression
trees (CART).

PMID: 12283399 [PubMed - indexed for MEDLINE]


129. J Biosoc Sci. 1990 Jan;22(1):121-35.

Women's childhood experience of parental separation and their subsequent health
and socioeconomic status in adulthood.

Kuh D, Maclean M.

MRC National Survey of Health and Development, University College, London.

The long term consequences for women of parental divorce and separation in
childhood are explored using data from a national, prospective, longitudinal
survey. In comparison with women who suffered no parental loss, parental divorce 
is associated with lower educational attainment and occupational status, poorer
mental health, higher alcohol consumption and higher rates of remarriage. Links
with earlier signs of emotional disturbance and current levels of stress are
explored.

PMID: 2298757 [PubMed - indexed for MEDLINE]


130. Br J Ind Med. 1989 Aug;46(8):582-5.

Cancer mortality in the asphalt industry: a ten year follow up of an occupational
cohort.

Hansen ES.

Institute of Community Health, University of Odense, Denmark.

A historical cohort study was conducted to study the possible risk of cancer
associated with exposure to asphalt. Altogether 1320 unskilled workers employed
in the asphalt industry were followed up over a ten year period and compared with
43,024 unskilled men in terms of cause specific mortality. Both groups were
identified from census records and followed up by an automatic record link that
had been established previously between the census register, National Register,
and Death Certificate Register. The cancer mortality was significantly increased 
in asphalt workers aged 45 or more, when five years' latency from enrolment into 
the study was allowed for (SMR for cancer: 159, 95% confidence interval:
106-228). Non-significant increases were seen for respiratory, bladder, and
digestive cancers but a significant increase was seen for brain cancer (SMR =
500, 95% CI: 103-1461). Components of asphalt fumes may have been important to
the observed association between risk of cancer and employment in the asphalt
industry.

PMCID: PMC1009830
PMID: 2775679 [PubMed - indexed for MEDLINE]


131. Inquiry. 1988 Winter;25(4):504-16.

The dynamics of Medicaid enrollment.

Short PF, Cantor JC, Monheit AC.

Division of Intramural Research, National Center for Health Services Research,
Rockville, MD 20857.

This longitudinal study examines transitions on and off Medicaid in the 1984
Panel of the Survey of Income and Program Participation. A majority of those
enrolled at the outset, but just 43% of those enrolled at any time during the
32-month survey, remained on Medicaid throughout. While slightly less than half
of those departing the program subsequently enjoyed improved employment, private 
insurance, and higher incomes, nearly half were still poor and 55% became
uninsured, indicating that persons who lost their Medicaid cards were in real
danger of being without insurance and financial access to health care--a serious 
disincentive to get off welfare.

PMID: 2976051 [PubMed - indexed for MEDLINE]


132. Inquiry. 1988 Fall;25(3):315-27.

The dynamics of health insurance loss: a tale of two cohorts.

Monheit AC, Schur CL.

Division of Intramural Research, National Center for Health Services Research,
Rockville, MD 20857.

Past research has characterized the uninsured population in fairly static terms. 
Little is known about the transition between insured and uninsured states, the
length of time persons remain uninsured, the existence of multiple spells of
health insurance loss, and the extent to which uninsured persons subsequently
acquire private or public coverage. In this paper we examine these dynamic
aspects of health insurance coverage for cohorts of privately insured and
uninsured persons over a 32-month period. The uninsured population was found to
be quite heterogeneous, consisting of many persons who lost coverage for
relatively short periods of time, others who were periodically without insurance,
and many who were persistently uninsured. Implications for public policy
initiatives for the uninsured population are also discussed.

PMID: 2972617 [PubMed - indexed for MEDLINE]


133. J Chronic Dis. 1987;40(10):949-57.

Social network interaction and mortality. A six year follow-up study of a random 
sample of the Swedish population.

Orth-Gomér K, Johnson JV.

This study examined the relationship between social network interaction and total
and cardiovascular mortality in 17,433 Swedish men and women between the ages of 
29 and 74 during a 6 year follow-up period. The study group was interviewed
concerning their social network interactions and a total score was formed which
summarized the availability of social contact. A number of sociodemographic and
health related background variables known to be associated with mortality risk
were also considered. Mortality was examined by linking the interview material
with the Swedish National Mortality Registry. In the 6-year follow-up period 841 
deaths occurred. The crude relative risk of dying during this period was 3.7 (95%
CL 3.2; 4.3) when the lower social network tertile was compared to the upper two 
tertiles. When controlling for potential confounding effects, only age had a
major influence on the association between social network interaction and
mortality (RR age-adjusted = 1.46, 95% CL 1.25; 1.72). Controlling for age and
sex, age and educational level, age and employment status, age and immigrant
status, age and smoking, age and exercise habits and age and chronic disease at
interview left the relative risk virtually unchanged. Controlling simultaneously 
for age, smoking, exercise and chronic illness yielded a risk estimate of 1.36
(95% CL 1.06; 1.69). Similar results were obtained when separately analyzing for 
cardiovascular disease mortality in an identical manner.

PMID: 3611293 [PubMed - indexed for MEDLINE]


134. Int J Cardiol. 1985 Nov;9(3):378-80.

Education and employability of young cardiac patients.

Robida A.

Between 1966-1980, 136 young cardiac patients were categorized as disabled in
accordance with the National Act of Rehabilitation. To study their fate a
questionnaire was circulated to them: 96 patients responded, all were 15 years of
age or more at the time of the study; 31.2% attended middle or higher school
education and 63.3% were employed; 45.9% were skilled and 54.1% unskilled
workers; 2.2% were unemployed, which was very close to the general youth
unemployment rate. Work was provided for unemployed patients in their homes but
they needed additional financial support. The benefits for the young disabled
cardiac patients include health insurance, vocational training, payment of
boarding school fees and financial support. Nevertheless the focus of the team
dealing with these patients should be their preparation for employment.

PMID: 4055155 [PubMed - indexed for MEDLINE]


135. South Med J. 1974 May;67(5):587-91.

Out-state charity neurology clinics: appraisal and follow-up of a comprehensive
neurology project in a thinly populated area.

Haerer AF, Wiygul FM Jr, Parish G.

PMID: 4406358 [PubMed - indexed for MEDLINE]

1. Soc Sci Med. 2009 Jan;68(1):49-59. Epub 2008 Nov 17.

A multi-group cross-lagged analyses of work stressors and health using Canadian
National sample.

Ibrahim S, Smith P, Muntaner C.

Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, Canada 
M5G 2E9. sibrahim@iwh.on.ca

This article examines the reciprocal relationships between work variables and
health outcomes and if these relationships differ by social class (measured by
occupational grouping). We used longitudinal data from the 1994/95--2002/03
Canadian National Population Health Survey (NPHS). Karasek's work stress
variables were measured in the 1994/95 (cycle 1, time 1), 2000/01 (cycle 4, time 
2) and 2002/03 (cycle 5, time 3) surveys. Analyses were limited to 2556
respondents aged 18-56 at time 1 and who remained in the same social class (as
defined by occupational position) for all the three time points. Work variables
used were job strain ratio, work social support and job insecurity. Health
outcomes used were distress, depression and self-rated health. Multi-group path
analyses were used to investigate the reciprocal relationships between work and
health variables and if these relationships differed by social class. Analyses
controlled for age, gender, marital status and work status. We find there is a
differential burden of work psychosocial factors and health outcomes by social
class. The cross-lagged relationships between work and health depended on the
outcome, social class and time lag. More significant paths from work to health
were observed than reverse paths from health to work. More significant
relationships between work and health were observed for the shorter time lag (2
years) compared to longer time lags (6 years). Low work social support and job
insecurity were more detrimental to health for respondents in lower social class 
positions. Findings from this study highlight the importance of time lag, and to 
some extent social class, in the reciprocal relationships between work and
health.

PMID: 19010577 [PubMed - indexed for MEDLINE]


2. Int J Tuberc Lung Dis. 2008 Oct;12(10):1160-5.

Factors contributing to treatment success among tuberculosis patients: a
prospective cohort study in Bangkok.

Okanurak K, Kitayaporn D, Akarasewi P.

Department of Social and Environmental Medicine, Faculty of Tropical Medicine,
Mahidol University, Bangkok, Thailand. tmkok@mahidol.ac.th

SETTING: Chest Clinic, Ministry of Public Health and health care centres, Bangkok
Metropolitan Administration. OBJECTIVE: To determine patient factors predicting
successful tuberculosis (TB) treatment. DESIGN: A prospective cohort was
conducted during May 2004 to November 2005. Newly diagnosed TB patients aged > or
= 15 years were recruited after giving informed consent. Three sets of
questionnaires were used to collect data from the patients three times. Data were
also gathered from treatment cards. RESULTS: Of 1241 patients, 81.1% were
successfully treated. Bivariate analysis indicated that patients' sex, education,
occupation, level of knowledge about TB and adverse effects were associated with 
treatment success. Unconditional logistic regression analysis showed that females
had a higher success rate than males (OR = 1.9, 95%CI 1.2-2.9). Patients with
regular incomes had twice the likelihood of success of the unemployed (OR = 2.0, 
95%CI 1.1-3.5). Patients with high knowledge levels were more likely to complete 
treatment (OR = 2.0, 95%CI 1.2-3.4), while those with adverse effects were less
likely to adhere (OR = 0.6, 95%CI 0.4-0.9). CONCLUSION: The current low treatment
success rate may be partly due to inadequate knowledge about TB among patients.
Improvements in health education and early detection and management of adverse
effects should be prioritised by the National Tuberculosis Programme.

PMID: 18812046 [PubMed - indexed for MEDLINE]


3. Occup Environ Med. 2009 Mar;66(3):150-3. Epub 2008 Sep 19.

Socio-economic differences in the association between sickness absence and
mortality: the prospective DREAM study of Danish private sector employees.

Lund T, Kivimäki M, Christensen KB, Labriola M.

Danish National Centre for Social Research, Herluf Trolles Gade 11, Copenhagen,
Denmark. tlu@sfi.dk

OBJECTIVES: To examine duration of sickness absence as a risk marker for future
mortality by socio-economic position among all private sector employees in
Denmark in 1998-2004. METHODS: All residents in Denmark employed in the private
sector receiving sickness absence compensation in 1998 were investigated in a
prospective cohort study. 236 207 persons (38.2% women, 61.8% men, age range
18-65, mean age 37.8 years) alive on 1 January 2001 were included in the study.
Mortality from 1 January 2001 to 31 December 2004 was assessed using national
register data. Deaths in 1999 and 2000 were excluded to determine the status of
sickness absence duration as an early risk marker. For analyses within
occupational grades, data were available for a sub-population of 137 607 study
participants. RESULTS: 3040 persons died during follow-up. The age-adjusted risk 
of future mortality increased by duration of sickness absence in a graded fashion
among men and non-blue collar workers. Among women and blue collar workers, there
was no association of mortality with duration of sickness absences below 6 weeks.
However, employees with > or =6 weeks of absence compared to those with 1-week
absence had a substantial excess risk of death in all groups: adjusted hazard
ratio 2.2 (95% CI 1.8 to 2.7) for women, 2.1 (95% CI 1.8 to 2.4) for men, 3.7
(95% CI 1.9 to 7.2) in white collar occupations, 3.3 (95% CI 2.2 to 5.0) in
intermediate grade occupations and 2.0 (95% CI 1.7 to 2.3) in blue collar
occupations. CONCLUSION: Administratively collected data on sickness absence
compensation for periods > or =6 weeks identified "at risk" groups for future
excess mortality in male and female private sector employees across occupational 
grade levels.

PMID: 18805885 [PubMed - indexed for MEDLINE]


4. Health Econ. 2009 May;18(5):535-48.

Weight and wages: fat versus lean paychecks.

Han E, Norton EC, Stearns SC.

Institute for Health Research and Policy, University of Illinois at Chicago,
Chicago, IL 60608, USA. eunahan@uic.edu

Past empirical work has shown a negative relationship between the body mass index
(BMI) and wages in most cases. We improve on this work by allowing the marginal
effect of non-linear BMI groups to vary by gender, age, and type of interpersonal
relationships required in each occupation. We use the National Longitudinal
Survey of Youth 1979 (1982-1998). We find that the often-reported negative
relationship between the BMI and wages is larger in occupations requiring
interpersonal skills with presumably more social interactions. Also, the wage
penalty increases as the respondents get older beyond their mid-twenties. We show
that being overweight and obese penalizes the probability of employment across
all race-gender subgroups except black women and men. Our results for the
obesity-wage association can be explained by either consumers or employers having
distaste for obese workers. (c) 2008 John Wiley & Sons, Ltd.

PMID: 18677723 [PubMed - indexed for MEDLINE]


5. J Prev Med Public Health. 2008 May;41(3):200-7.

Psychological distress and occupational injury: findings from the National Health
Interview Survey 2000-2003.

Kim J.

Department of Environmental Health, Harvard School of Public Health, USA.
jaeykim@hsph.harvard.edu

OBJECTIVES: This study examined whether serious psychological distress (SPD) is
associated with occupational injury among US employees. METHODS: The employed
population aged 18-64 years was examined (n=101,855) using data from the National
Health Interview Survey (NHIS) 2000-2003. SPD was measured using the Kessler
6-item Psychological Distress Scale (K-6), a screening scale designed to identify
persons with serious mental illness. The predicted marginal prevalence of
psychological distress and occupational injury with the adjusted odds ratio were 
estimated using multiple logistic regression analyses. RESULTS: The age-adjusted 
3-month prevalence of occupational injury was 0.80 +/- 0.12% in workers with SPD,
which was 37% greater than in workers without SPD (0.58 +/- 0.03%). The odds of
occupational injury in workers with SPD were higher compared to workers without
SPD (OR=1.34, 95% CI=0.93-1.92), after controlling for sex, age, race, education,
occupation, and activity limitation by at least one medical condition. Male,
service and blue collar occupation, and activity limiation by co-morbidity showed
significantly higher odds of occupational injury for workers with SPD.
CONCLUSIONS: The findings suggest that SPD accounts for an increased likelihood
of occupational injury among US employees. A further longitudinal study is needed
to differentiate the mechanism or causal pathways linking individual injury risk 
at the workplace, SPD, and socioeconomic factors.

PMID: 18515998 [PubMed - indexed for MEDLINE]


6. Occup Environ Med. 2008 Feb;65(2):120-5. Epub 2007 Aug 6.

Mortality, morbidity and occupational exposure to airway-irritating agents among 
men with a respiratory diagnosis in adolescence.

Wiebert P, Svartengren M, Lindberg M, Hemmingsson T, Lundberg I, Nise G.

Dr P Wiebert, Department of Occupational and Environmental Health, Norrbacka,
Karolinska Hospital, SE-171 76 Stockholm, Sweden; pernilla.wiebert@sll.se.

OBJECTIVES: To examine the influence of an airway diagnosis in adolescence on
future health and occupation in Swedish men. METHODS: Data were collected from
the linkage of four Swedish national registers: the Military Service Conscription
Register, the Population and Housing Censuses, the Inpatient Care Register and
the National Cause of Death Register. A job-exposure matrix for airway-irritating
substances was developed for application on the conscription cohort. The cohort
included 49 321 Swedish men born 1949-51. Three groups-(1) healthy, (2)
asthmatics (mild and severe asthma) and (3) subjects with allergic rhinitis
without concurrent asthma-were identified at conscription and analysed for
mortality, in-patient care and strategies for choice of occupation with emphasis 
on airway-irritating job exposure. Analyses were adjusted for smoking and
childhood socioeconomic position. RESULTS: The prevalence of total asthma was
1.8%, severe asthma 0.45% and allergic rhinitis 2.7%. Mortality for all causes
was significantly higher in total asthma, hazard ratio (HR) 1.49 (95% CI 1.00 to 
2.23), and lower in allergic rhinitis, HR 0.52 (95% CI 0.30 to 0.91). Asthma was 
a risk factor for inpatient care while allergic rhinitis was associated with less
in-patient care (odds ratio (OR) for total asthma 1.16 (95% CI 1.00 to 1.34),
severe asthma 1.38 (95% CI 1.04 to 1.85), allergic rhinitis 0.92 (95% CI 0.82 to 
1.03)). Those with asthma tended to avoid jobs with a high probability for
airway-irritating exposure (OR 0.88, 95% CI 0.71 to 1.09), but not to the same
extent as subjects with allergic rhinitis (OR 0.58, 95% CI 0.47 to 0.70) (ORs
from 1990). CONCLUSION: Subjects with asthma did not change their exposure
situation to the same extent as subjects with allergic rhinitis. Further,
asthmatics had an increased risk for morbidity and mortality compared to healthy 
subjects and subjects with allergic rhinitis.

PMID: 17681997 [PubMed - indexed for MEDLINE]


7. Ann Epidemiol. 2007 Aug;17(8):608-14. Epub 2007 May 23.

Socioeconomic position in childhood and adulthood and weight gain over 34 years: 
the Alameda County Study.

Baltrus PT, Everson-Rose SA, Lynch JW, Raghunathan TE, Kaplan GA.

National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA, USA.
pbaltrus@msm.edu

PURPOSE: Socioeconomic position (SEP) has been shown to be related to obesity and
weight gain, especially among women. It is unclear how different measures of
socioeconomic position may impact weight gain over long periods of time, and
whether the effect of different measures vary by gender and age group. We
examined the effect of childhood socioeconomic position, education, occupation,
and log household income on a measure of weight gain using individual growth
mixed regression models and Alameda County Study data collected over thirty four 
years(1965-1999). METHODS: Analyses were performed in four groups stratified by
gender and age at baseline: women, 17-30 years (n = 945) and 31-40 years (n =
712); men, 17-30 years (n = 766) and 31-40 years (n = 608). RESULTS: Low
childhood SEP was associated with increased weight gain among women 17-30 (0.13
kg/year, p < 0.001). Low educational status was associated with increased weight 
gain among women 17-30 (0.14 kg/year, p = 0.030), 31-40 (0.14 kg/year, p =
0.014), and men 17-30 (0.20 kg/year, p = 0.001). CONCLUSION: Log household income
was inversely associated with weight gain among men 31-40 (-0.10 kg/yr, p =
0.16). Long-term weight gain in adulthood is associated with childhood SEP and
education in women and education and income in men.

PMID: 17521922 [PubMed - indexed for MEDLINE]


8. Work. 2007;28(3):225-30.

Who is at risk for long-term sickness absence? A prospective cohort study of
Danish employees.

Lund T, Labriola M, Villadsen E.

National Institute of Occupational Health, Copenhagen, Denmark.

AIM: The aim of this study was to identify who is at risk for long-term sickness 
absence according to occupation, gender, education, age, business sector, agency 
size and ownership. METHODS: The study is based on a sample of 5357 employees
aged 18-69, interviewed in 2000. The cohort was followed up in a national
register from January 1st 2001 to June 30th 2003, to identify cases with sickness
absences that exceeded 8 weeks. RESULTS: During follow-up 486 persons (9.1%)
experienced one or more periods of absence that exceeded 8 weeks. Higher risk of 
long-term sickness absence was associated with gender, age, educational level,
and the municipal employment sector. Kindergarten teachers and people employed in
day care, health care, janitorial work, food preparation, and unskilled workers
were at greatest risk. Managers, computer professionals, technicians and
designers, and professionals had lower risks. The health care and social service 
sectors were also in the high risk category, whereas the private administration
sector had a lower risk. CONCLUSIONS: The study identifies specific occupational 
target populations and documents the need to perform job-specific research and
tailor interventions if the intended policy of decreasing long-term sickness
absence within the Danish labour market is to be realized.

PMID: 17429148 [PubMed - indexed for MEDLINE]


9. Health Rep. 2006 Oct;17(4):11-29.

Stress and depression in the employed population.

Shields M.

Health Statistics Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
Margot.Shields@statcan.ca

OBJECTIVES: This article describes stress levels among the employed population
aged 18 to 75 and examines associations between stress and depression. DATA
SOURCES: Data are from the 2002 Canadian Community Health Survey: Mental Health
and Well-being and the longitudinal component of the 1994/95 through 2002/03
National Population Health Survey. ANALYTICAL TECHNIQUES: Stress levels were
calculated by sex, age and employment characteristics. Multivariate analyses were
used to examine associations between stress and depression in 2002, and between
stress and incident depression over a two-year period, while controlling for age,
employment characteristics, and factors originating outside the workplace. MAIN
RESULTS: In 2002, women reported higher levels of job strain and general
day-to-day stress. When the various sources of stress were considered
simultaneously, along with other possible confounders, for both sexes, high
levels of general day-to-day stress and low levels of co-worker support were
associated with higher odds of depression, as was high job strain for men. Over a
two-year period, men with high strain jobs and women with high personal stress
and low co-worker support had elevated odds of incident depression.

PMID: 17111591 [PubMed - indexed for MEDLINE]


10. Am J Ind Med. 2006 Dec;49(12):997-1004.

Twenty-three years of hypersensitivity pneumonitis mortality surveillance in the 
United States.

Bang KM, Weissman DN, Pinheiro GA, Antao VC, Wood JM, Syamlal G.

National Institute for Occupational Safety and Health, Centers for Disease
Control and Prevention, Morgantown, West Virginia 26505, USA. kmb2@cdc.gov

BACKGROUND: There are few population-based studies addressing hypersensitivity
pneumonitis (HP) in the United States. The National Institute for Occupational
Safety and Health (NIOSH) has nationally comprehensive longitudinal mortality
data that can contribute to a better understanding of the epidemiology of HP.
METHODS: The National Center for Health Statistics multiple cause-of-death data
were analyzed for the period 1980-2002. Annual death rate was age-adjusted to the
2000 U.S. standard population. Death rate time-trends were calculated using a
linear regression model and geographic distribution of death rates were mapped by
state and county. Proportionate mortality ratios (PMRs) by usual industry and
occupation adjusted for age, sex, and race, were based on data from 26 states
reporting industry and occupation during 1985-1999. RESULTS: Overall age-adjusted
death rates increased significantly (P < 0.0001) between 1980 and 2002, from 0.09
to 0.29 per million. Wisconsin had the highest rate at 1.04 per million. Among
industries, PMR for HP was significantly high for agricultural production,
livestock (PMR, 19.3; 95% CI, 14.0-25.9) and agricultural production, crops (PMR,
4.3; 95% CI, 3.0-6.0). Among occupations, PMR for HP was significantly elevated
for farmers, except horticulture (PMR, 8.1; 95% CI, 6.4-10.2). CONCLUSIONS: These
findings indicate that agricultural industries are closely associated with HP
mortality and preventive strategies are needed to protect workers in these
industries.

PMID: 17096370 [PubMed - indexed for MEDLINE]


11. Minerva Pediatr. 2006 Jun;58(3):211-8.

Fetal alcohol syndrome and its long-term effects.

Merrick J, Merrick E, Morad M, Kandel I.

National Institute of Child Health and Human Development, Faculty of Health
Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel.
jmerrick@internet-zahav.net

Ancient scripture and paintings together with several medical reports on the
effect of alcohol on the newborn over the past 300 years finally led to the
description of the fetal alcohol syndrome in the 1970s by French and American
research groups. Maternal alcohol abuse during pregnancy can result in the
specific pattern of malformations and neurocognitive deficits characteristic of
this syndrome. Diagnostic criteria and classifications have been developed and in
the 1990s reports showed the long-term consequences for these children. In recent
years several studies from different countries have shown that prenatal alcohol
exposure will lead to life-long consequences on physical development,
intellectual development, behavior, social development, occupation, independence,
sexuality or sexual behavior and increased risk of suicidality. In this review of
long-term observation studies we found that the prenatal exposure to alcohol have
permanent and life-long damage, which impair both the social and occupational
future of the person exposed with a need for life-long assistance in order for
that person to function at an optimal level. Primary prevention and early
intervention with general public health educational efforts seems to be the best 
way forward.

PMID: 16832326 [PubMed - indexed for MEDLINE]


12. Arch Dermatol. 2006 Mar;142(3):305-11.

Prognosis of occupational hand eczema: a follow-up study.

Cvetkovski RS, Zachariae R, Jensen H, Olsen J, Johansen JD, Agner T.

Department of Dermatology, Gentofte Hospital, University of Copenhagen, Hellerup,
Denmark.

Comment in:
    Arch Dermatol. 2006 Mar;142(3):362-4.

OBJECTIVE: To identify prognostic risk factors in patients with occupational hand
eczema (OHE). DESIGN: Cohort study with 1-year follow-up. SETTING: Danish
National Board of Industrial Injuries Registry. PATIENTS: All patients with newly
recognized OHE (758 cases) from October 1, 2001, through November 10, 2002.
INTERVENTIONS: Participants received a questionnaire covering self-rated
severity, sick leave, loss of job, depression, and health-related quality of
life. One year after the questionnaire was returned, all responders (N = 621)
received a follow-up questionnaire, and 564 (91%) returned it. MAIN OUTCOME
MEASURES: Persistently severe or aggravated OHE, prolonged sick leave, and loss
of job after 1-year follow-up. RESULTS: During the follow-up period, 25% of all
patients with OHE had persistently severe or aggravated disease, 41% improved,
and 34% had unchanged minimal or mild to moderate disease. Patients with atopic
dermatitis fared poorly compared with other patients. Patients younger than 25
years fared clearly better than older groups. Furthermore, severe OHE, age 40
years or greater, and severe impairment of quality of life at baseline appeared
to be important predictors of prolonged sick leave and unemployment. Patients
with lower socioeconomic status also had a high risk of prolonged sick leave, job
change, and loss of job. Contact allergy was not found to be a risk factor for
poor prognosis. CONCLUSIONS: Atopic dermatitis, greater age, and low
socioeconomic status may be reliable prognostic factors in early OHE. Quality of 
life and standardized severity assessment may also be valuable tools to identify 
patients at high risk of prolonged sick leave and unemployment.

PMID: 16549705 [PubMed - indexed for MEDLINE]


13. Southeast Asian J Trop Med Public Health. 2005 Jul;36(4):822-31.

Surveillance of imported bancroftian filariasis after two-year multiple-dose
diethylcarbamazine treatment.

Koyadun S, Bhumiratana A.

Office of Disease Prevention and Control 11, Nakhon Si Thammarat, Department of
Disease Control, Ministry of Public Health, Nakhon Si Thammarat, Thailand.

Myanmar migrants are at increased risk for nocturnally periodic Wuchereria
bancrofti causing imported bancroftian filariasis. They have a significant
influence on the effectiveness of diethylcarbamazine (DEC) mass treatment at the 
provincial level in the National Program to Eliminate Lymphatic Filariasis (PELF)
during the fiscal years (FY) 2002-2006, in Thailand. Two oral doses of DEC 6
mg/kg are given twice a year to the eligible Myanmar migrants (> or = 2 years
old). A 300 mg DEC provocation test is given once a year to all Myanmar migrants 
with work permits. Effectiveness evaluation parameters, such as cumulative index 
(CI) and the effectiveness ratio (ER), were obtained after 2 years of the
multiple-dose DEC treatment program in Ranong Province, Southern Thailand. By
cross-sectional night blood surveys at the end of FY 2003 in two districts of
Ranong Province, the microfilarial positive rates (MPR) were 0.8% and 1.2% for
Mueang Ranong and Kra Buri, respectively. The MPR in the agricultural (1.5%) and 
industrial (0.4%) occupations were not significantly different from each other.
Our findings suggest that most untreated microfilaremics working in agriculture, 
with short-term residency in Thailand, may have delayed multiple-dose DEC
treatment.

PMID: 16295532 [PubMed - indexed for MEDLINE]


14. Saudi Med J. 2005 Oct;26(10):1617-23.

Socioeconomic determinants of inequality and self-reported morbidity among
adolescents in a developing country.

Avila-Burgos L, Ramirez-Valverde G, Martinez-Damian MA, Cruz-Valdez A,
Santiago-Cruz MJ, Medina-Solis CE.

Center for Health Systems Research, National Institute of Public Health,
Cuernavaca, Morelos, Mexico. cemedinas@yahoo.com

OBJECTIVE: Studies about health inequalities among adolescents have been
conducted principally in developed countries. Although adolescents represent 15% 
of the Mexican population, no studies are available in this specific age group on
health inequalities. In this study, we assess differences in the perception of
morbidity severity among adolescent students, as well as their association with
selected socioeconomic characteristics. METHODS: We carried out a cross-sectional
study (base-line of a longitudinal study of adolescent's health) in 1999.
Participants were Mexican adolescents (n=12769) aged 12-19 years, attending to
public schools selected through of multistage sampling method. We measured the
health status through a self-reported morbidity in 2 weeks time. We included
several socioeconomic indicators and for statistical analysis we used the
multinomial logistic regression model. RESULTS: The prevalence of self-reported
health problems was 32%. Women had 23% increased odds for reporting health
problems. Age was positively associated to frequency and severity of health
problems; also, there was a positive association with the mother's occupation,
one-parent homes, and not owning an automobile. CONCLUSIONS: Morbidity reporting 
rates are higher than expected in this population. Moderate reporting levels are 
found among social groups, especially when health problems were perceived as
moderately severe, suggesting the importance of socioeconomic factors as
determinants. Further studies should conducted using different kinds of health
indicators in this age group.

PMID: 16228067 [PubMed - indexed for MEDLINE]


15. Food Nutr Bull. 2005 Jun;26(2 Suppl 1):S25-45.

Social and economic development and change in four Guatemalan villages:
demographics, schooling, occupation, and assets.

Maluccio JA, Melgar P, Méndez H, Murphy A, Yount KM.

Department of Global Health, Rollins School of Public Health, Emory University,
Atlanta, GA 20006, USA. J.Maluccio@cgiar.org

This article uses census data and village histories to examine changes over the
last 35 years in the four villages where the Institute of Nutrition of Central
America and Panama (INCAP) Longitudinal Study (1969-77) was conducted and offers 
a rare picture of development and change in rural localities over a long period
of time. In addition, by characterizing the environment in which the subjects of 
this study were raised, we provide context for and inputs into quantitative
analyses of data collected at various points in time on these subjects. The
villages have undergone massive demographic, social, and economic change. Initial
differences have conditioned many of these changes, especially differences
associated with agricultural potential and location. Originally these villages
were rather isolated, but road and transportation access has improved
substantially. The populations in the villages have more than doubled and also
have aged. While marriage patterns have held steady, religious practice has
changed a great deal. After many years of steady out-migration, three of the four
villages are more recently experiencing net in-migration, a pattern associated
with ease of access. Schooling access and outcomes also have improved, with
average grades of schooling nearly tripling and literacy doubling to levels
currently above national averages. Although agriculture remains an important
component of individual livelihood strategies, non-agricultural sources of
employment have become more important. Much of this change is associated with
declining agricultural markets and increased access to non-agricultural jobs near
the villages and in the capital. Accompanying these changes has been an
improvement in living standards as measured by a number of indicators of
household living conditions and consumer durable goods.

PMID: 16060210 [PubMed - indexed for MEDLINE]


16. Eur J Public Health. 2005 Oct;15(5):511-7. Epub 2005 Jul 21.

Mortality among 723,948 foreign- and native-born Swedes 1970-1999.

Albin B, Hjelm K, Ekberg J, Elmståhl S.

School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
bjorn.albin@ivosa.vxu.se

BACKGROUND: Mortality in a population is regarded as an accurate and valid
measure of the population's health. There are a few international studies,
predominantly cross-sectional, of mortality among all foreign-born compared with 
an indigenous population, and the results have varied. No Swedish longitudinal
study describing and analysing mortality data was found in a literature review.
METHODS: This study describes and analyses the differences in mortality between
foreign-born persons and native Swedes during the period 1970-1999, based on data
from Statistics Sweden and the National Board of Health and Welfare. The database
consisted of 723,948 persons, 361 974 foreign-born living in Sweden in 1970, aged
> or = 16 years, and 361 974 Swedish controls matched for age, sex, occupation
and type of employment, living in the same county in 1970. RESULTS: The results
showed increased mortality for foreign-born persons compared with the Swedish
controls [odds ratio (OR) 1.08; 95% confidence interval (CI) 1.07-1.08]. Persons 
who had migrated 'late' (1941-1970) to Sweden were 2.5 years younger at time of
death than controls. In relation to country of birth, the highest risk odds were 
for men born in Finland (OR 1.21), Denmark (OR 1.11) and Norway/Iceland (OR
1.074). Age cohorts of foreign-born persons born between 1901 and 1920 had higher
mortality at age 55-69 years than cohorts born between 1921 and 1944.
CONCLUSIONS: Migrants had higher mortality than the native population, and
migration may be a risk factor for health; therefore, this seems to be an
important factor to consider when studying mortality and health.

PMID: 16037077 [PubMed - indexed for MEDLINE]


17. Eur J Public Health. 2004 Dec;14(4):417-21.

Smoking from adolescence to adulthood: the effects of parental and own
socioeconomic status.

Paavola M, Vartiainen E, Haukkala A.

National Public Health Institute, Department of Epidemiology and Health
Promotion, Helsinki, Finland. meri_paavola@yahoo.com

BACKGROUND: The aim of the study was to examine the effects of parental
socioeconomic status, own socioeconomic status and social mobility upon the
development of smoking from adolescence to adulthood. METHODS: Subjects were the 
participants of the North Karelia Youth Project study from six schools in Eastern
Finland. At the baseline in 1978 they were 13 year-olds (n=903) and in the last
of the six surveys in 1993 they were 28-year-olds. The parents were studied in
1978 and 1980. The association between smoking and socioeconomic status was
measured by education, occupation and income in adolescence and adulthood, and
social mobility was measured by the difference between parental and own
education. RESULTS: In general, parental socioeconomic status was not
significantly associated with the subjects' smoking in adolescence or adulthood. 
Own socioeconomic status measured at the age of 21 and 28 was strongly related to
smoking. Those who were most educated in adulthood had smoked the least already
from the age of 13. Social mobility was not significantly associated with
smoking. CONCLUSION: The study stresses the importance of own socioeconomic
status in relation to smoking, but parental socioeconomic status or social
mobility does not have direct effects on smoking. Socioeconomic differences in
smoking should be understood as an important determinant for health inequalities.

PMID: 15542880 [PubMed - indexed for MEDLINE]


18. Scand J Work Environ Health. 2004 Oct;30(5):362-70.

Central nervous system effects of acute organophosphate poisoning in a two-year
follow-up.

Delgado E, McConnell R, Miranda J, Keifer M, Lundberg I, Partanen T, Wesseling C.

Department of Preventive Medicine, Occupational Health Program, National
Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua.

OBJECTIVES: Patients hospitalized for acute organophosphate poisoning in León,
Nicaragua, were followed for effects on the central nervous system (CNS) over a
2-year period. METHODS: Immediate verbal memory (Rey verbal learning), visuomotor
performance (digit symbol), and neuropsychiatric symptoms (Q-16) were assessed
for 53 poisoned persons at the time of hospital discharge, 7 weeks postpoisoning,
and 2 years postpoisoning, and, at the same time intervals, for 28 persons who
had never been poisoned. The poisonings were classified as moderate occupational 
(31), severe occupational (15), and severe through the oral route (7),
representing low, medium, and high exposure, respectively. Longitudinal
confounder-adjusted between-category comparisons and longitudinal analyses of
variance and covariance were used to assess the effects of the exposure. RESULTS 
:Immediate verbal learning showed deficits in the high-exposure group, in
particular at the time of discharge, but the estimate of the difference when
compared with the values of the unexposed was imprecise. Visuomotor performance
showed a deficit at 7 weeks in the medium-exposure group, but it had improved
after 2 years relative to that of the unexposed, for whom improvement had
occurred at 7 weeks and persisted during the 2 years of follow-up, possibly a
test-retest effect. Neuropsychiatric symptoms were in excess 2 years after the
hospital discharge in the low- and medium-exposure groups and all the groups
combined. All the results were imprecise for the small high-exposure group.
CONCLUSIONS: Visuomotor performance and possibly short-term verbal memory seem to
be affected early after severe acute organophosphate poisoning and recover,
either truly or by some compensatory mechanism. Neuropsychiatric symptoms seem to
increase after a longer latency period.

PMID: 15529800 [PubMed - indexed for MEDLINE]


19. Niger J Med. 2004 Oct-Dec;13(4):355-8.

Chronic osteomyelitis of long bones: reasons for delay in presentation.

Onche II, Obiano SK.

Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.

BACKGROUND: Chronic osteomyelitis is a common orthopaedic infection and a major
medical problem in developing countries. Time is a critical factor in the
evolution of the chronic disease as most of our cases are a progression from
acute haematogenous osteomyelitis. Our patients present very late. OBJECTIVE: To 
identify the reasons for this delayed presentation and suggest possible
solutions. METHOD: Over three years (2000-2003) in a multi-centre study
(2000-2003), we prospectively evaluated patients with both clinical and
radiological diagnosis of chronic osteomyelitis. Besides personal data, mode of
onset, duration of illness, father's educational status and occupation and
reasons for delayed presentation were documented using a questionnaire. Previous 
surgery was an exclusion criterion. RESULTS: One hundred and thirty-six patients 
comprising 81 males and 55 females with a mean age of 17.7(2-55) years were
recruited. The mean duration between onset of disease and presentation for
treatment was 13.3(2-120) months. Sixty-one (44.9%) presented to a health
facility were misdiagnosed and inappropriately treated; ignorance was the reason 
in 37(27.2%) and lack of finances in 32(23.2%). There was no statistically
significant association between the father's educational status and occupation
and the attitude to hospital attendance. CONCLUSION: Misdiagnosis, ignorance and 
poverty are the reasons for delayed presentation in patients with chronic
osteomyelitis in this environment. A high index of suspicion, accurate diagnosis 
and appropriate therapy offer the only hope in containing the acute phase.
Continuing medical education, improvement in social and medical amenities and the
national health insurance scheme are possible ways of overcoming undue delay in
presentation for specialist consultation.

PMID: 15523861 [PubMed - indexed for MEDLINE]


20. Sex Transm Dis. 2004 Sep;31(9):533-41.

Family socioeconomic status and self-reported sexually transmitted diseases among
black and white american adolescents.

Newbern EC, Miller WC, Schoenbach VJ, Kaufman JS.

Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel
Hill, North Carolina 27599-7435, USA.

OBJECTIVE: The objective of this study was to assess associations between
socioeconomic status (SES) and adolescent sexually transmitted diseases (STDs)
stratified by race and gender. STUDY: In cross-sectional analyses of the National
Longitudinal Study of Adolescent Health Wave One (1995), unadjusted and adjusted 
associations between 4 family SES indicators and STD reports for black and white 
7th through 12th graders were examined. RESULTS: Lower maternal education and
nonprofessional maternal occupations were associated with higher STD reports in
all groups except white females. Generally, STD reports were higher for
adolescents not living in 2-parent homes, and lower income was only associated
for black males. CONCLUSION: Overall, SES is only a weak to moderate marker for
adolescent STD risks. The relationship of SES and STDs varies by the SES measure 
used and differs across race-gender groups. Other individual factors such as risk
behaviors or community factors such as income inequality could play a more
critical role for adolescent STDs than family SES.

PMID: 15480114 [PubMed - indexed for MEDLINE]


21. Fam Pract. 2004 Aug;21(4):355-63.

Adjusting for case mix and social class in examining variation in home visits
between practices.

Sullivan CO, Omar RZ, Forrest CB, Majeed A.

Public Health Policy Unit, School of Public Policy, University College London,
UK. caoimhe.osullivan@uclh.nhs.uk

OBJECTIVES: The purpose of this study was to investigate whether adjusting for
clinical case mix and social class explains more of the variation in home visits 
between general practices than adjusting for age and sex alone. METHODS: The
setting was 60 general practices in England and Wales taking part in the 1 year
Fourth National Morbidity Survey. The participants comprised 349 505 patients who
were registered with one of the participating general practices for at least 180 
days, and who had at least one consultation during the period. The outcome
measure is whether or not a patient received a home visit in that year. A
clinical case mix category (morbidity class) based on 1 year's diagnostic
information was assigned to each patient using the Johns Hopkins Adjusted
Clinical Groups (ACG) Case Mix System. The social class measure was derived from 
occupation and employment status and is similar to that of the 1991 UK census.
Variations in home visits between practices were examined using multilevel
logistic regression models. The variability between practices before and after
adjusting for clinical case mix and social class was estimated using the
intracluster correlation coefficient (ICC). RESULTS: The overall percentage of
patients receiving a home visit over the 1 year study period was 17%, and this
varied from 7 to 31% across the 60 practices. The percentage of the total
variation in home visits attributable to differences between practices was 2.5%
[95% confidence interval (CI) 1.4-3.2%] after adjusting for age and sex. This
reduced to 1.6% (95% CI 1.1-2.4%) after taking into account morbidity class. The 
results were similar when social class was included instead of morbidity class.
Morbidity and social class together reduced variation in home visits between
practices to 1.5% (95% CI 1.1-2.2%). CONCLUSIONS: Age, sex, social class and
clinical case mix are strong determinants of home visits in the UK. Adjusting for
morbidity and social class results in a small improvement in explaining the
variability in home visits between practices compared with adjusting for age and 
sex alone. There is far more variation between patients within practices;
however, it is not straightforward to examine the factors influencing this
variation. In addition to morbidity and social class, there could also be other
unmeasured factors such as varying patient demand for home visits, disability or 
differences in GP home visiting practice style that could influence the large
within-practice variability observed in this study.

PMID: 15249522 [PubMed - indexed for MEDLINE]


22. Transplantation. 2003 Dec 27;76(12):1699-704.

Quality of life in adult survivors beyond 10 years after liver, kidney, and heart
transplantation.

Karam VH, Gasquet I, Delvart V, Hiesse C, Dorent R, Danet C, Samuel D,
Charpentier B, Gandjbakhch I, Bismuth H, Castaing D.

Centre Hépato Biliaire, Hôpital Paul Brousse, 4 Avenue Paul Vaillant-Couturier,
94804 Villejuif Cedex, France. vincent.karam@pbr.ap-hop-paris.fr

BACKGROUND: The yearly increasing survival rates testify to the success of
transplantation, but questions remain relating to the quality of life (QOL)
associated with long-term survival. METHODS: A sample of 126 liver recipients
(Liver-R), 229 kidney recipients (Kidney-R), and 113 heart recipients (Heart-R)
with more than 10 years posttransplant follow-up were included in the study with 
a response rate of 86%. Respondents were matched with healthy subjects recruited 
from general population (GP). The three groups of recipients and GP subjects
completed a French version of the questionnaire used by the National Institute of
Diabetes and Digestive and Kidney Disease, Pittsburgh, PA, and were compared for 
each score, with adjustments for age and sex. RESULTS: Personal function and
measures of disease by the transplant recipients were significantly worse than in
the GP (P<0.0001), with the worst score in Kidney-R. No difference, either
between organs or between organs and GP, was found regarding the perceived social
and role function. However, for psychologic status and general health perception,
Kidney-R had the least favorable performance when compared with GP (P<0.01) and
also when compared with Liver-R (P<0.05). With the exception of Kidney-R, the
well-being index of Liver-R and Heart-R was significantly better than the GP
(P<0.001 and P<0.05, respectively). CONCLUSIONS: The QOL beyond 10 years after
liver, heart, and kidney transplantation is quite similar to the GP, with
Kidney-R starting out as the worst, Heart-R as intermediate, and Liver-R the
best.

PMID: 14688519 [PubMed - indexed for MEDLINE]


23. Am J Public Health. 2003 Jun;93(6):994-8.

Cigarette smoking and cognitive decline in midlife: evidence from a prospective
birth cohort study.

Richards M, Jarvis MJ, Thompson N, Wadsworth ME.

Medical Research Council, National Survey of Health and Development, University
College London, London, England. m.richards@ucl.ac.uk

OBJECTIVES: The authors investigated the effects of cigarette smoking on midlife 
cognitive performance. METHODS: Multiple regression was used to test the
association between cigarette smoking and changes in cognitive test scores among 
male and female members of the British 1946 birth cohort aged between 43 and 53
years. RESULTS: Smoking was associated with faster declines in verbal memory and 
with slower visual search speeds. These effects were largely accounted for by
individuals who smoked more than 20 cigarettes per day and were independent of
sex, socioeconomic status, previous (adolescent) cognitive ability, and a range
of health indicators. CONCLUSIONS: The present results show that heavy smoking is
associated with cognitive impairment and decline in midlife. Smokers who survive 
into later life may be at risk of clinically significant cognitive declines.

PMCID: PMC1447882
PMID: 12773367 [PubMed - indexed for MEDLINE]


24. Am J Psychiatry. 2003 May;160(5):939-46.

Family disruption in childhood and risk of adult depression.

Gilman SE, Kawachi I, Fitzmaurice GM, Buka SL.

Department of Maternal and Child Health, Harvard School of Public Health, 677
Huntington Avenue, Boston, MA 02115, USA. sgilman@hsph.harvard.edu

OBJECTIVE: The authors examined the risk that family disruption and low
socioeconomic status in early childhood confer on the onset of major depression
in adulthood. METHOD: Participants were 1,104 offspring of mothers enrolled
during pregnancy in the Providence, R.I., site of the National Collaborative
Perinatal Project. Measures of childhood family disruption and socioeconomic
status were obtained before birth and at age 7. Structured diagnostic interviews 
were used to assess respondents' lifetime history of major depressive episode
between the ages of 18 and 39. Survival analysis was used to identify childhood
risks for depression onset. RESULTS: Parental divorce in early childhood was
associated with a higher lifetime risk of depression among subjects whose mothers
did not remarry as well as among subjects whose mothers remarried. These effects 
were more pronounced when accompanied by high levels of parental conflict.
Independent of the respondents' adult socioeconomic status, low socioeconomic
status in childhood predicted an elevated risk of depression. CONCLUSIONS: Family
disruption and low socioeconomic status in early childhood increase the long-term
risk for major depression. Reducing childhood disadvantages may be one avenue for
prevention of depression. Identification of modifiable pathways linking aspects
of the early childhood environment to adult mental health is needed to mitigate
the long-term consequences of childhood disadvantage.

PMID: 12727699 [PubMed - indexed for MEDLINE]


25. Int J Epidemiol. 2002 Dec;31(6):1183-91.

Social determinants of disability pension: a 10-year follow-up of 62 000 people
in a Norwegian county population.

Krokstad S, Johnsen R, Westin S.

Department of Community Medicine and General Practice, Norwegian University of
Science and Technology, Trondheim, Norway. steinar.krokstad@medisin.ntnu.no

BACKGROUND: Non-medical factors may be important determinants for granting
disability pension (DP) even though disability is medically defined, as in
Norway. The aim of this analysis was to identify determinants of DP in a total
county population in a 10-year follow-up study. METHODS: Participants were people
without DP, 20- to 66-years-old in 1984-1986. The baseline data were obtained in 
the Nord-Trøndelag Health Study (HUNT): 90 000 people were invited to answer
questionnaires on health, disease, social, psychological, occupational, and
lifestyle factors. Information on those who later received DP was obtained from
the National Insurance Administration database in 1995. Data analyses were
performed using Cox regression analyses. RESULTS: The incidence of DP showed
great variation with regards to age and gender, accounting for an overall
increase in the follow-up period. Low level of education, low self-perceived
health, occupation-related factors and any long-standing health problem were
found to be the strongest independent determinants of DP. Low level of education 
and socioeconomic factors contributed more to younger people's risk compared to
those over 50 years. For people under 50 years of age with a low level of
education compared to those with a high level of education, the age-adjusted
relative risk for DP was 6.35 for men and 6.95 for women. The
multivariate-adjusted relative risk was 2.91 and 4.77, respectively. CONCLUSIONS:
Even for a medically based DP, low socioeconomic status, low level of education
and occupational factors might be strong determinants when compared to medical
factors alone. These non-medical determinants are usually not addressed by
individual based health or rehabilitation programmes.

PMID: 12540720 [PubMed - indexed for MEDLINE]


26. Bull Soc Pathol Exot. 2002 Aug;95(3):167-71.

[Epidemiology of snake bites in the Republic of Ivory Coast]

[Article in French]

Chippaux JP.

Institut de recherche pour le développement (IRD), B. P. 1 386, Dakar, Sénégal.
chippaux@ird.sn

A national survey was carried out in Côte d'Ivoire in 1979 in order to evaluate
the incidence, morbidity and mortality of snakebites. This unpublished survey has
not been renewed to our knowledge. Although 20 odd years have passed since, the
survey is not obsolete and can be usefully presented at this congress. We
associated a retrospective survey using health centre registers and a prospective
survey performed in 7 health centres between 1972 and 1979. The incidence,
estimated prospectively for rural areas, exceeded 200 bites for 100,000
inhabitants. This evaluation could be an underestimation because many victims
consulted traditional practitioners. Annual morbidity was higher in forest areas 
(195 envenomations per 100,000 inhabitants) than in the savannah (130
envenomations per 100,000 inhabitants). Conversely, the case fatality rate was
higher in the savannah (3.1%) than in forest areas (2%). More than half of the
bites involved men aged 15 to 50 years. The risks were significantly higher for
farmers, particularly in industrial plantations, where 27% of the total of number
of bites involved 1.5% of the population. At the beginning of the 1980s,
envenomations could be estimated at over 13,000 per 8 million inhabitants and the
number of deaths 200 per annum.

PMID: 12404862 [PubMed - indexed for MEDLINE]


27. East Afr Med J. 2001 Nov;78(11):564-7.

Autologous transfusion in surgical patients at Kenyatta National Hospital,
Nairobi.

Magoha GA, Mwanda WO, Afulo OK.

Department of Surgery, College of Health Sciences, University of Nairobi.

Comment in:
    East Afr Med J. 2001 Nov;78(11):561-3.

OBJECTIVE: To identify autotransfusion strategies and their basis in elective
surgery patients. DESIGN: A cross sectional prospective study. SETTING: General
surgery and orthopaedic wards, Kenyatta National Hospital, Nairobi. SUBJECTS:
Adult patients of both sexes planned for elective surgery. MAIN OUTCOME MEASURE: 
Forevery patient, the following were enquired about and documented: age in years,
sex, ethnicity, religion, occupation and educational standard. Blood values of
haemoglobin, platelet counts, total and differential white cell counts, urea,
electrolytes and liver function tests were assayed. Others were the number of
units of blood donated before the operation, the type of surgery performed, time 
taken from diagnosis to performing the operation and whether the blood was
transfused preoperatively, intraoperatively and postoperatively. RESULTS: A total
of sixty three cases constituting five per cent of all surgical patients admitted
during the period of study were evaluated. Of these 53 (84%) were males and ten
(16%) females. The age range was 15 to 65 years with a peak at 45-49 years. There
were more Christians (90%) than Muslims (10%). In all, 32 (51.6%) had primary
school education, 23 (36.5%) secondary school education, seven (11.3%) no formal 
education and one (1.6%) had attained college level. Employment pattern showed
50% were civil servants, 30% were self employed and 20% were unemployed. The
duration of disease ranged from 1-24 weeks with two peaks at two weeks and six
weeks. Orthopaedic cases constituted 78.7% and general surgery 21.3%.
Preoperative haemoglobin ranged from 13.5-14.2 g/dl. Transfusions were given
intraoperatively to 41 (66.1%) and to 12 (33.9%) postoperatively. Mean duration
of hospitalisation was 13 days (range 5 to 21 days). 98.4% deposited only one
unit while 1.6% deposited four units of blood. Only one patient required
additional transfusion from homologous donors. CONCLUSION: The strategies and
basis for autotransfusion have been demonstrated among a majority of adult
patients requiring orthopaedic procedures. Major determinants are shown to be
baseline blood count profiles and time to operation.

PMID: 12219960 [PubMed - indexed for MEDLINE]


28. Nord J Psychiatry. 2001;55(4):263-70.

Outcome of drug abuse in a 20-year follow-up study of drug-experimenting
schoolchildren in Finland.

Turpeinen P.

National Public Health Institute, Helsinki, Finland.

The fate of 119 drug-experimenting schoolchildren who had been interrogated by
the narcotics police of Helsinki, Finland, during 1 year, 1971-72, was studied 20
years later. The material was divided in two groups: those with a favourable
outcome (n=49) and those with a poor outcome (n=70). Nineteen had died. Criteria 
for poor outcome were death, prison sentence, psychiatric hospitalization, or
continuation of crimes. The group with a favourable outcome was alive, did not
have prison sentences or psychiatric hospitalizations, and had not been caught by
the police after the initial phase of the study. Offences against property in
early adolescence and intravenous drug use were predictive factors for
imprisonment, psychiatric hospitalization, and death. A poor atmosphere at home
and the occupation of the father as labourer were predictive factors for
imprisonment, psychiatric hospitalization, and death for boys. For girls low
education was predictive of imprisonment and psychiatric hospitalization. Drug
use in adolescence is a signal of greater risk for adjustment problems in later
life.

PMID: 11839117 [PubMed - indexed for MEDLINE]


29. Int J Obes Relat Metab Disord. 2000 Dec;24(12):1642-7.

Determinants of overweight tracking from childhood to adolescence: a 5 y
follow-up study of Hat Yai schoolchildren.

Mo-suwan L, Tongkumchum P, Puetpaiboon A.

Department of Pediatrics, Faculty of Medicine, Prince of Songkhla University,
Thailand. mladda@ratree.psu.ac.th

OBJECTIVE: To study the determinants of overweight tracking from childhood to
adolescence of Hat Yai schoolchildren. DESIGN: A longitudinal study. SETTING:
Primary and secondary schools of Hat Yai municipality, southern Thailand.
SUBJECTS: 2252 schoolchildren recruited in 1992 and follow-up for 5y.
MEASUREMENTS: Child's annual body mass index (BMI, kg/m2) from 1992 to 1997;
parental BMIs, parental income, and family history of diseases by a questionnaire
completed by parents in 1992. RESULTS: Prevalence of overweight of males using
the 85th percentile of the U S First National Health and Nutritional Examination 
Survey reference for age and sex as a cut-off point increased from 12.4% in 1992 
to 21% in 1997, whereas that of females went down from 15.2 to 12.6. At the end
of the fifth year, 11.8% of children remained overweight while 4.5% became
overweight. Comparing to the non-overweights, the risk for becoming an overweight
adolescent of an overweight boy was 8.2 (95% confidence interval (CI) = 6, 11.2) 
whereas that of the overweight girls was 20 (95% CI = 12.4, 32.3). The
generalized estimating equations model predicted an increase in child BMI
associated with having a father or a mother with high BMI, a family history of
obesity, a monthly income greater than 5000 baht, and a lower level of exercise
than their peers. Secular increase in BMI was also observed. CONCLUSION:
Predictors of overweight tracking found in this study would be useful to select
children at risk for preventive intervention.

PMID: 11126218 [PubMed - indexed for MEDLINE]


30. Med Lav. 2000 Jul-Aug;91(4):366-78.

[ESTEV study on relationship between health, work and aging in Italy]

[Article in Italian]

Barbini N, Squadroni R.

Osservatorio Epidemiologico Lavoratori Anziani I.N.R.C.A., Ancona.

A longitudinal epidemiological study into the relationships between
age/health/work is currently under way in different geographical areas throughout
Italy. The research is co-ordinated by INRCA (Italian National Research Centres
on Aging) in Ancona with the collaboration of the Universities of Ancona, Verona 
and Bari. This study concerns a population of approximately 2,000 employees from 
a variety of production sectors. The sample is made up of 5 groups of workers
selected according to the year they were born and aged: 32, 37, 42, 47 and 52
years. The chosen research tool is modelled on ESTEV and VISAT researches, the
former conducted on a sample of 20,000 French workers, the latter on
approximately 3,000 workers and still under way. It involves a set of three
questionnaires which allow for a number of variables to be taken into
consideration: the first questionnaire concentrates on information regarding the 
occupation, both past and present; the second on the life style and self-assessed
health according to the Nottingham Health Profile (NHP); the third, completed by 
the occupational physician, contains information on current and previous
illnesses, the presence of disorders of the musculo-skeletal apparatus, the
taking of any drugs and some anthropometrical and clinical-instrumental
parameters (Respiratory Functionality Test, Visiotest and Audiogram). The study
with be carried out in two phases: a first survey (under way) and a second one
five years later on the same subjects. The results of the analysis will be
compared with those of other European countries.

PMID: 11098600 [PubMed - indexed for MEDLINE]


31. Int J STD AIDS. 2000 May;11(5):313-23.

Sexually transmitted infections and use of sexual health services among young
Australian women: women's health Australia study.

Schofield MJ, Minichiello V, Mishra GD, Plummer D, Savage J.

School of Health, University of New England, Armidale, New South Wales,
Australia.

Our objective was to examine associations between self-reported sexually
transmitted infections (STIs) and sociodemographic, lifestyle, health status,
health service use and quality of life factors among young Australian women; and 
their use of family planning and sexual health clinics and associations with
health, demographic and psychosocial factors. The study sample comprised 14,762
women aged 18-23 years who participated in the mailed baseline survey for the
Australian Longitudinal Study on Women's Health, conducted in 1996. The main
outcome measures are self report of ever being diagnosed by a doctor with an STI,
including chlamydia, genital herpes, genital warts or other STIs, and use of
family planning and sexual health clinics. The self-reported incidence of STI was
1.7% for chlamydia, 1.1% genital herpes, 3.1% genital warts, and 2.1% other STIs.
There was a large number of demographic, health behaviour, psychosocial and
health service use factors significantly and independently associated with
reports of having had each STI. Factors independently associated with use of
family planning clinic included unemployment, current smoking, having had a Pap
smear less than 2 years ago, not having ancillary health insurance, having
consulted a hospital doctor and having higher stress and life events score.
Factors independently associated with use of a sexual health clinic included
younger age, lower occupation status, being a current or ex-smoker, being a binge
drinker, having had a Pap smear, having consulted a hospital doctor, having
poorer mental health and having higher life events score. This study reports
interesting correlates of having an STI among young Australian women aged 18-23. 
The longitudinal nature of this study provides the opportunity to explore the
long-term health and gynaecological outcomes of having STIs during young
adulthood.

PMID: 10824940 [PubMed - indexed for MEDLINE]


32. Am J Public Health. 1999 Oct;89(10):1522-8.

The role of socioeconomic status gradients in explaining differences in US
adolescents' health.

Goodman E.

Division of Adolescent Medicine, Children's Hospital Medical Center, University
of Cincinnati, Ohio 45229, USA. goode0@chmcc.org

OBJECTIVE: This study sought to determine whether socioeconomic status (SES)
gradients exist among US adolescents for self-rated health and for 5 diseases
that cause serious adolescent and continuing adult morbidity. METHODS: Baseline
data from 15,483 adolescent and parental surveys from the National Longitudinal
Study of Adolescent Health were used. SES indicators included parental education 
and occupation, and household income. Dependent variables included self-rated
health and the presence of depression, obesity, asthma, suicide attempt in the
past year, and prior sexually transmitted disease. RESULTS: SES gradients were
found for self-rated health, depression, and obesity (P < .01). Suicide attempt
was linearly associated with income (P < .01). After adjustment for other SES and
sociodemographic factors, education and income remained independent correlates of
both depression and obesity; income remained an independent correlate of
attempted suicide. CONCLUSIONS: Differences in susceptibility to socially
mediated etiologic mechanisms of disease may exist during adolescence.
Understanding the sociostructural context and patterning of adolescents' lives is
crucial to clearly understanding health and disease etiology throughout the
course of life.

PMCID: PMC1508793
PMID: 10511834 [PubMed - indexed for MEDLINE]


33. Cephalalgia. 1999 Jun;19(5):503-10.

Incremental absenteeism due to headaches in migraine: results from the Mig-Access
French national cohort.

Michel P, Dartigues JF, Duru G, Moreau J, Salamon R, Henry P.

CCECQA, CHU Bordeaux, France. philippe.michel@ph.u-bordeaux2.fr

OBJECTIVE: To assess the costs of headache-related absenteeism of
community-dwelling migraineurs, and to compare the amount of absenteeism between 
migraineurs aged 18 and older and age, sex, and occupation-matched
nonheadache-prone subjects. DESIGN: Follow-up over a 3-month period. SAMPLES: 385
migraineurs and 313 nonheadache subjects representative of the setting. METHODS: 
Every day, the participants recorded the presence of headache, if any, and the
work situation (unemployment, holiday, weekend, medical reason, nonmedical
reason). Sickness-related absenteeism was the number of workdays missed or
interrupted for medical reasons. Headache-related absenteeism was the
sickness-related absenteeism during workdays with headaches. The annual
headache-related absenteeism costs in France were extrapolated from these data in
accordance with the mean income per occupational category. The incremental
absenteeism and related costs were the difference between the two samples.
RESULTS: Of working migraineurs, 20% had at least one period of absenteeism.
During the 3 months, they missed or interrupted on average 1.4 days for medical
reasons, 0.25 of which for headaches. Sickness-related absenteeism was
statistically higher in migraineurs than in nonheadache-prone subjects. This
difference was due to a higher absenteeism for comorbidity reasons, not for
headache reasons, representing 20% of all sickness-related absenteeism.
Migraineurs avoided sick leave for headache reasons. As an incremental total,
1.68 days or approximately 0.7% of the annual number of working days are lost on 
average per individual with migraine. The annual incremental headache-related
absenteeism cost was 5.22 billions, i.e. 1,551 FF (US$240) per migraineur.

PMID: 10403066 [PubMed - indexed for MEDLINE]


34. Soc Sci Med. 1998 Dec;47(12):2043-53.

Social class, assets, organizational control and the prevalence of common groups 
of psychiatric disorders.

Muntaner C, Eaton WW, Diala C, Kessler RC, Sorlie PD.

Institute of Occupational and Environmental Health and Prevention Research
Center, West Virginia University, Morgantown 26506-9190, USA.

This study provides an update on the association between social class and common 
types of psychiatric disorder in the US. In addition to usual measures of social 
class, we provide hypotheses for the expectation that assets and organizational
control are associated with specific varieties of psychiatric disorders (mood,
anxiety, alcohol and drug use disorders). We analyzed two surveys. The National
Comorbidity Survey conducted in 1990-1992 yielded 12-month prevalence rates in a 
probability sample of 8098 respondents in the 48 contiguous states. The
Epidemiologic Catchment Area Follow-up conducted in 1993-1996 provided similar
rates among 1920 East Baltimore residents. Analyses of the National Comorbidity
Survey showed an inverse association between financial and physical assets and
mood, anxiety, alcohol, and drug disorders. The Epidemiologic Catchment Area
Followup provided additional evidence for the inverse association between
financial and physical assets and anxiety, alcohol and drug disorders. Also in
the Epidemiologic Catchment Area, lower level supervisors presented higher rates 
of depression and anxiety disorders than higher level managers. Inequalities in
assets and organizational control, as well as typical measures of social class,
are associated with specific psychiatric disorders. These constructs can provide 
additional explanations for why social inequalities in psychiatric disorders
occur.

PMID: 10075245 [PubMed - indexed for MEDLINE]


35. J Epidemiol Community Health. 1998 Oct;52(10):651-6.

Incidence and occupational pattern of leukaemias, lymphomas, and testicular
tumours in western Ireland over an 11 year period.

Kelleher C, Newell J, MacDonagh-White C, MacHale E, Egan E, Connolly E, Gough H, 
Delaney B, Shryane E.

Department of Health Promotion, National University of Ireland, Galway.

STUDY OBJECTIVE: To determine incidence of the following malignancies, testicular
tumours, all leukaemias and all lymphomas in the West of Ireland in an 11 year
period. Secondly, to examine the relation between disease patterns and available 
occupational data in male subjects of working age. DESIGN: A census survey of all
cases occurring in the three counties in the Western Health Board (WHB) area,
Galway, Mayo and Roscommon, for the 11 year period 1980 to 1990 inclusive.
Average annual age standardised incidence rates for the period were calculated
using the 1986 census data. Rates for the area are compared with rates from the
southern region of Ireland, which had a tumour registry. Trends over the time
period are evaluated. All male subjects for whom occupational data were available
were categorised using the Irish socioeconomic group classification and incidence
rates by occupation were compared using the standardised incidence ratio method. 
In one of the counties, Galway, a detailed occupational history of selected cases
and an age matched control group was also elicited through patients' general
practitioners. SETTING: All available case records in the West of Ireland.
RESULTS: There are no national incidence records for the period. Compared with
data from the Southern Tumour Registry, the number of cases of women with myeloid
leukaemias was significantly lower. Male leukaemia rates were significantly lower
as a group (SIR 84 (95% CI 74, 95) but not when considered as individual
categories. Regression analysis revealed an increasing trend in the number of new
cases of non-Hodgkin's lymphoma among both men (r = 0.47, p = 0.02) and women (r 
= 0.90, p = 0.0001) and of chronic lymphocytic leukaemia in men (r = 0.77, p =
0.005) and women (r = 0.68 p = 0.02) in the WHB region over the last decade. Four
hundred and fifty six male cases over the age of 15 years were identified and
adequate occupational information was available for 74% of these. Standardised
incidence ratios of testicular tumours 100, 938) and agriworkers other than
farmers (SIR 377, 95% CI 103, 967). There were also significantly increased
incidence ratios for both non-Hodgkin's lymphoma (SIR 169, 95% CI 124, 266) and
three categories of leukaemias among farmers. Hodgkin's disease and acute myeloid
leukaemias were significantly increased among semi-skilled people. Interview data
with 90 cases and 54 controls of both sexes revealed that among farmers, cases (n
= 31) were significantly less likely than controls (n = 20) to use tractor
mounted spraying techniques (OR = 0.19 (95% CI 0.04, 0.80)) and less likely to
wear protective masks (OR 0.22 (95% CI 0.05, 0.84)). CONCLUSIONS: Trends of
increase in non-Hodgkin's lymphoma and some leukaemias are consistent with
studies elsewhere. The study provides further evidence of the relation between
agricultural work and certain lymphoproliferative cancers. The possible
carcinogenic role of chemicals used in agricultural industries must be considered
as an explanation.

PMCID: PMC1756621
PMID: 10023465 [PubMed - indexed for MEDLINE]


36. Am J Prev Med. 1998 Nov;15(4):344-61.

Worksite physical activity interventions.

Dishman RK, Oldenburg B, O'Neal H, Shephard RJ.

Department of Exercise Science, University of Georgia, Athens 30602-6554, USA.

BACKGROUND: National objectives for public health have targeted worksite as
important settings for interventions to increase physical activity. However,
expert reviews reveal no scientific consensus about the effectiveness of worksite
interventions for increasing physical activity or fitness. METHODS: We judged the
quantity and quality of existing evidence against scientific standards for the
internal and external validity of the research design and the validity of
measurements. Meta-analytic methods were used to quantify the size of effects
expressed as Pearson correlation coefficients (r). Variation in effect was
examined in relation to several features of the studies deemed important for
implementing successful worksite interventions. Pre-experimental cohort studies
were excluded because they are sensitive to secular trends in physical activity. 
RESULTS: Twenty-six studies involving nearly 9,000 subjects yielded 45 effects.
The mean effect was heterogeneous and small, r = 0.11 (95% CI, -0.20 to 0.40),
approximating 1/4 S.D., or an increase in binomial success rate from 50% to 56%. 
Although effects varied slightly according to some of the study features we
examined, effects were heterogeneous within levels of these features. Hence, the 
moderating variables examined did not explain variation in the effects (P >
0.05). The exception was that effects were smaller in randomized studies compared
with studies using quasi-experimental designs (P < 0.05). CONCLUSIONS: Our
results indicate that the typical worksite intervention has yet to demonstrate a 
statistically significant increase in physical activity or fitness. The few
studies that have used an exemplary sample, research design, and outcome measure 
have also yielded small or no effects. The generally poor scientific quality of
the literature on this topic precludes the judgment that interventions at
worksites cannot increase physical activity or fitness, but such an increase
remains to be demonstrated by studies using valid research designs and measures.

PMID: 9838977 [PubMed - indexed for MEDLINE]


37. Cerebrovasc Dis. 1998 Sep-Oct;8(5):296-302.

Functional recovery and social outcome after cerebral infarction in young adults.

Neau JP, Ingrand P, Mouille-Brachet C, Rosier MP, Couderq C, Alvarez A, Gil R.

University Department of Neurology, CHU La Miletrie, University of Poitiers,
Poitiers, France.

This study was designed to assess the return to work, the poststroke depression
and the quality of life after a cerebral infarction in young adults and was
conducted on 71 consecutive young patients (aged 15-45 years) affected by a
cerebral infarct who were hospitalized for the first time and discharged at least
1 year before the study. Data about risk factors, etiology, side and territory of
stroke, social characteristics of the patient (age, sex, profession, educational 
level, family situation), poststroke seizures, recurrent stroke, other vascular
events, and deaths were collected. Neurological deficits were graded with the
National Institutes of Health (NIH) Stroke Scale. Poststroke depression (PSD) was
quantified using the DSM-IIIR criteria and the Montgomery Asberg Depression
Rating Scale. Outcomes were rated with the Ranking Scale, the Barthel Index and
the Glasgow Outcome Scale. Quality of life was assessed with the Sickness Impact 
Profile. Follow-up information was obtained by interview and neurological
examination. Follow-up information was obtained in 65 patients at a mean of 31.7 
+/- 13.0 (range 12-59) months, as 2 patients died and 4 were lost to follow-up
and were thus excluded from this study. Poststroke seizures occurred in 7
patients (10.8%) and recurrent strokes in 4 patients (6.2%), but none were fatal.
The outcome after stroke among survivors was usually good, since more than
two-thirds of the patients (69.8%) reported no problem, 11.1% moderate handicap
and one-fifth major handicap. Forty-six patients (73%) returned to work: the time
period ranging from several days after stroke to 40 months, with a mean of 8
months. However, adjustments in their occupation were necessary for 12 patients
(26.1%). PSD was common, since 48.31% of the patients were classified as
depressed. PSD was associated with the localization of the infarct (carotid
territory), a severe disability, a bad general outcome, and an absence of return 
to work. Their opinion about their quality of life was negative among
approximately 30% of the patients, especially in emotional and alertness
behaviors. social interaction, recreation and pastimes. The general outcome after
cerebral infarct in young adults is usually good. However, the risk of a PSD is
high, and only half of the patients had returned to their previous work. A
remaining psychosocial handicap and depression of sexual activity impaired the
quality of life. In multivariate analysis, a low NIH score at admission is a
significant predictor for return to work, the absence of PSD, and a good quality 
of life.

PMID: 9712928 [PubMed - indexed for MEDLINE]


38. Pediatrics. 1998 Aug;102(2):e25.

Parental literacy level and understanding of medical information.

Moon RY, Cheng TL, Patel KM, Baumhaft K, Scheidt PC.

Department of General Pediatrics, Children's Research Institute, Children's
National Medical Center, Washington, DC 20010, USA.

OBJECTIVE: To ascertain the impact of literacy level on parents' understanding of
medical information and ability to follow therapy prescribed for their children. 
DESIGN/METHODS: A prospective cohort of parents accompanying their children for
acute care. Parents were interviewed about demographic status, their child's
health, and use of pediatric preventive services. The Rapid Estimate of Adult
Literacy in Medicine (REALM) test was used to assess parental literacy. The same 
parent was interviewed 48 to 96 hours later and asked to recall the child's
diagnosis, any medication prescribed, and instructions. RESULTS: A total of 633
patients were enrolled. Follow-up was obtained in 543 patients (85.8%). Mean
parental age was 32.43 years (SD = 9.07). Mean REALM score was 57.6 (SD = 10.9), 
corresponding to a 7th- to 8th-grade reading level, with a mean parental
educational level of 13.43 years (SD = 2.09). Low REALM score was significantly
correlated with young parental age and parental education. African-American race 
was associated with lower REALM scores. After controlling for these variables,
REALM score significantly correlated with parental perception of how sick the
child was, but not with use of preventive services, comprehension of diagnosis,
medication name and instructions, or ability to obtain and administer prescribed 
medications. CONCLUSIONS: Parental literacy level did not correlate with use of
preventive services or parental understanding of or ability to follow medical
instructions for their children.

PMID: 9685471 [PubMed - indexed for MEDLINE]


39. Surg Laparosc Endosc. 1997 Apr;7(2):140-3.

Minimally invasive approach for the treatment of idiopathic varicocele.

Spaziani E, Silecchia G, Ricci S, Raparelli L, Materia A, Fantini A, Basso N.

II Clinica Chirurgica, Policlinico Umberto I, Università degli Studi di Roma La
Sapienza, Italy.

Laparoscopic ligation of the spermatic veins represents a new approach for the
treatment of the idiopathic varicocele. This procedure was performed in 28
consecutive patients. The diagnosis was based on physical examination and Doppler
ultrasonography. The indications for surgery were (a) infertility and abnormal
semen analyses (15 patients), (b) scrotal pain (six patients), and (c)
psychological reasons (seven patients). One patient underwent concomitant
hernioplasty. Two cases presented with a recurrence after 6 and 12 months,
respectively. The mean operative time was 34 +/- 11 min in unilateral cases and
47 +/- 9 min in bilateral cases. In one patient with left inguinal hernia and
varicocele, the operative time was 70 min. All patients were discharged the day
after operation without antibiotics and analgesics and resumed normal activity
within 5 to 9 days, depending on age and occupation. Postoperative semen analyses
(at 12 months' follow-up) were obtained from seven patients and demonstrated an
improvement in semen motility (preoperative 40% versus postoperative 56%). This
study confirms that laparoscopic treatment of varicocele is safe, minimally
invasive, and, according to National Health Service fees, less costly than
radiological occlusion procedures.

PMID: 9109245 [PubMed - indexed for MEDLINE]


40. Spine (Phila Pa 1976). 1996 Oct 15;21(20):2352-5.

Prolapsed cervical intervertebral disc in male professional drivers in Denmark,
1981-1990. A longitudinal study of hospitalizations.

Jensen MV, Tüchsen F, Orhede E.

Department of Occupational Medicine, National Institute of Occupational Health,
Denmark, Copenhagen, Denmark.

STUDY DESIGN: This study of professional drivers is a part of a longitudinal
record linkage study of all economically active men in Denmark, identified on
January 1, 1981. Information about the main occupation was identified in 1980.
The cohort was followed for first hospitalization with prolapsed cervical
intervertebral disc until December 31, 1990. OBJECTIVES: To examine the risk of
prolapsed cervical intervertebral disc in all Danish professional drivers, and to
analyze exposures of the male drivers in a sample of all Danish male drivers.
SUMMARY OF BACKGROUND DATA: Only a few studies on occupation and prolapsed
cervical intervertebral disc have been published. These studies suggest that
professional driving may be a risk factor for development of prolapsed cervical
intervertebral disc. Drivers are exposed to whole-body vibrations, heavy lifting,
and a sedentary position. Other potential exposures are accelerations and
decelerations and whiplash accidents. Such exposure may be involved in the
causation of prolapsed cervical intervertebral disc. METHODS: A standardized
hospitalization ratio was calculated for each subgroup of drivers using all
economically active people as the standard. Additional exposure information was
extracted from a national survey on work environment. RESULTS: Almost all men in 
occupations involving professional driving had a statistically significant
elevated risk of being hospitalized with prolapsed cervical intervertebral disc. 
CONCLUSIONS: Professional driving is a risk factor for prolapsed cervical
intervertebral disc.

PMID: 8915070 [PubMed - indexed for MEDLINE]


41. Am J Ind Med. 1996 Oct;30(4):407-14.

Occupation and ischemic heart disease in the European Community: a comparative
study of occupations at potential high risk.

Tüchsen F, Andersen O, Costa G, Filakti H, Marmot MG.

National Institute of Occupational Health, Denmark, Copenhagen.

Four longitudinal studies of mortality and morbidity by occupation based on
individual record linkage of information and two cross-sectional studies of
mortality were compared in order to identify occupations at high risk of ischemic
heart disease. In more than one country an increased risk of ischemic heart
disease was found in drivers of buses, taxies, and lorries, in bakers, in naval
officers and fishermen, in hotel and restaurant workers, in senior police,
customs, and other uniformed men, in barbers and hairdressers, in warehouse and
wholesale staff, as well as in laboratory assistants and in radio and telegraph
operators. Occupations found at high risk in Denmark were also found at high risk
in Great Britain and Italy. These occupations may be at genuine high risk. None
of these groups work day-work only and several of the groups have psychologically
demanding work but unsatisfactory decision authority. Identification of
occupations at high risk may help to develop focused preventive strategies.

PMID: 8892545 [PubMed - indexed for MEDLINE]


42. Bull N Y Acad Med. 1996 Winter;73(2):370-97.

Occupations, cigarette smoking, and lung cancer in the epidemiological follow-up 
to the NHANES I and the California Occupational Mortality Study.

Leigh JP.

Department of Economics, San Jose State University, CA 95192-0114, USA.

What jobs are associated with the highest and lowest levels of cigarette use and 
of lung cancer? Are there gender differences in these jobs? Two data sets-the
Epidemiological Follow-up to the National Health and Nutrition Examination Survey
(NHEFS) and the California Occupational Mortality Study (COMS) were analyzed to
answer these questions. For females, the broad occupations ranking from highest
to lowest cigarette use in the NHEFS was: transportation operators, managers,
craft workers, service workers, operatives, laborers, technicians, administrative
workers, farm owners and workers, sales workers, no occupation, and
professionals. The corresponding ranking for males was: transportation operators,
no occupation, laborers, craft workers, service workers, technicians, and
professionals. The highest-ranking jobs in the COMS were waitresses, telephone
operators, and cosmetologists for women, and water-transportation workers,
roofers, foresters and loggers for men. Teachers were especially low on all four 
lists. This study could not determine whether employment within any occupation
encouraged smoking or if smokers selected certain occupations.

PMCID: PMC2359318
PMID: 8982527 [PubMed - indexed for MEDLINE]


43. Scand J Work Environ Health. 1995 Dec;21(6):427-34.

Musculoskeletal symptoms among sewing machine operators.

Schibye B, Skov T, Ekner D, Christiansen JU, Sjøgaard G.

National Institute of Occupational Health, Copenhagen, Denmark.

OBJECTIVES: A longitudinal study was conducted to describe the prevalences and
development of musculoskeletal symptoms among sewing machine operators in
relation to age and exposure and among former sewing machine operators who
changed exposure by changing occupation. METHODS: Musculoskeletal symptoms were
assessed among 327 sewing machine operators in 1985 with the use of the
standardized Nordic questionnaire. A follow-up study in 1991 showed that
approximately one-third was still working as a sewing machine operator, one-third
had changed occupation, and the rest were out of employment. The exposure was
assessed by a questionnaire regarding the type of machine being operated, work
organization, workplace design, units produced per day, and payment system.
RESULTS: High prevalences of musculoskeletal symptoms of the neck and shoulders
were found, with some associations to exposure variables such as efficiency.
Initially symptom-free sewing machine operators were not at a higher risk of
developing symptoms when they continued sewing during the six-year follow-up when
compared with those who changed to other employment. However, symptomatic sewing 
machine operators who quit sewing were much more likely to be relieved of their
symptoms than were symptomatic operators who continued sewing, odds ratio 3.26
[95% confidence interval (95% CI) 1.38-7.72] for 12-month symptoms and odds ratio
3.90 (95% CI 1.28-11.90) for 7-day symptoms. This trend also applied to
long-lasting symptoms. CONCLUSIONS: The results demonstrate that, for many sewing
machine operators, neck and shoulder symptoms are reversible and may be
influenced by reallocation to other worktasks.

PMID: 8824748 [PubMed - indexed for MEDLINE]


44. J Occup Environ Med. 1995 Oct;37(10):1199-203.

Occupational injury and stress.

Johnston JJ.

National Institute for Occupational Safety and Health, Morgantown, West Virginia 
26505-2888, USA.

A literature search was conducted to identify studies that measured the
relationship between stress and occupational injury. Studies that provided a
quantitative measure of stress and occupational injury and a quantitative
assessment of the relationship between these two factors were selected for this
review. Twenty studies were identified, and all had P values of less than .05 or 
odds ratios ranging from .3 to 4.6. Twelve of 17 measures had odds ratios greater
than 1.0. Several factors limit the generalizability of these results, however,
and these include methodological differences in the assessment of stress and
injury, study design, and limited representation of occupations.

PMID: 8542339 [PubMed - indexed for MEDLINE]


45. J Paediatr Child Health. 1995 Jun;31(3):200-6.

A profile of heart disease risk factors and their relation to parents' education,
fathers' occupation and family history of heart disease in 843 South Australian
families: the Adelaide Children's WHO Collaborative Study.

Boulton TJ, Cockington RA, Hamilton-Craig I, Magarey AM, Mazumdar J.

University of Newcastle, New South Wales, Australia.

OBJECTIVE: A study was conducted to determine whether the prevalence of risk
factors among pre-adolescent children is associated with their parents' risk
factor status and what influence family history of ischaemic heart disease (IHD) 
and socio-economic status (SES) had. METHODOLOGY: This was a cross-sectional
study of 856 children, mean age 8.6 years, and their parents who underwent the
World Health Organization and National Heart Foundation protocols for the study
of arteriosclerosis precursors. Historical, demographic, anthropometric, clinical
and biochemical outcome measures were used. RESULTS: There was the expected
burden of illness reported for the grandparents and parents, with the latter
conforming to their expected age group's heart disease risk factor status. The
mean serum total cholesterol (TC) level for boys was 4.43 (+/- 0.79) mmol/L and
girls 4.62 (+/- 0.84) mmol/L, with the 95th percentile for boys and girls
combined being 5.88 mmol/L. The level corresponding to two standard deviations
above the mean was 6.0 mmol/L. Childrens' IHD risk factor status reflected their 
parents' with TC, skin fold thickness and body mass index most closely
correlated, followed by blood pressure. The greatest correlation was between the 
childrens' TC and their mothers'. Socio-economic status as assessed by the
parents' education level and fathers' occupational status produced differences in
their childrens' risk factors, with mother's level of education having the major 
influence. There was no impact of family history of IHD. CONCLUSIONS: From these 
results it would appear that screening of the pre-adolescent may be appropriate
but longitudinal study will be important to establish this by documenting
persistence of risk factor status. Also, it would appear that a child's future
risk from IHD morbidity may be due to environmental influences mediated through
differences in SES. As the level of IHD risk factors is reduced within the
community, the extent of parent-child transmission of measurable IHD risk factors
in families of high IHD risk may be reduced.

PMID: 7669380 [PubMed - indexed for MEDLINE]


46. Am J Ind Med. 1995 Jun;27(6):793-805.

A detailed analysis of work-related injury among youth treated in emergency
departments.

Knight EB, Castillo DN, Layne LA.

Division of Safety Research, National Institute for Occupational Safety and
Health, Morgantown, West Virginia 26505, USA.

Telephone interviews were conducted with 146 14- to 16-year-olds who incurred an 
occupational injury treated in an emergency department during the period July
through September 1992. Thirty-two percent of the injuries occurred as the result
of using equipment. Over half the workers reported not having received prior
training on how to avoid injury. The injury limited normal activities for at
least 1 day for 68% of the youth and for more than a week for 25%, corresponding 
to an estimated 6,208 (95% CI: 4,277, 8,139) and 2,639 (95% CI: 1,580, 3,699)
youths nationwide, respectively. Employment in retail trades, equipment use, lack
of training, and burn injuries were associated with increased limitation of
normal activities. Nineteen percent of the youths appear to have been injured in 
jobs declared to be hazardous, or typically prohibited for their age (14- and
15-year-olds) under federal child labor laws. The prohibited job directly
contributed to the injury in 64% of these cases.

PMID: 7645574 [PubMed - indexed for MEDLINE]


47. Prev Med. 1994 Mar;23(2):235-41.

Cigarette smoking among former military service personnel: a neglected social
issue.

Feigelman W.

Department of Sociology, Nassau Community College, Garden City, New York 11530.

BACKGROUND. This article investigates cigarettes smoking among active military
personnel, veterans, and comparable civilian populations. METHODS. It is based on
secondary analysis of archival data from the General Social Surveys and the
National Longitudinal Surveys of Youth. RESULTS. Findings were consistent with
past research, indicating higher smoking rates for current active military
personnel than for civilians. Among men and women who were in their thirties
during the early 1980s, findings suggest that military personnel and civilians
alike exhibited the same tendency toward cigarette use and initiated smoking at
approximately the same ages. General Social Surveys and National Longitudinal
Surveys of Youth data suggest that military smoking did not appear to be a
situational behavior which occurred only during a recruit's tour of duty; results
also suggest that previous military experience was associated with higher
lifelong patterns of cigarette consumption, compared to those who had never been 
in the armed services. CONCLUSIONS. This evidence suggests that the military--as 
the nation's largest employer, with an immense influence upon civilian
relations--exerts a force of considerable magnitude thwarting national goals to
achieve reduced cigarette consumption.

PMID: 8047531 [PubMed - indexed for MEDLINE]


48. Scand J Prim Health Care. 1993 Dec;11(4):234-40.

A clinical follow up of unemployed. II: Sociomedical evaluations as predictors of
re-employment.

Claussen B.

National Institute of Public Health, Unit for Health Services Research, Oslo,
Norway.

OBJECTIVE--To frame and study sociomedical evaluations in clinical work with
unemployed people. DESIGN--In a two-year follow up of routine health
examinations, three sociomedical evaluations were set up. The first was the
direct conclusion of the check-up, based on sickness and possibilities of
treatment. The second dealt with work identity, and the last was a diagnostic set
of main unemployment problem. SETTING--The four municipalities of Grenland,
Norway. PARTICIPANTS--A representative sample aged 16 to 63 who had been
registered with the labour market authorities for more than 12 weeks.
RESULTS--21% of the unemployed needed further treatment. 7% were classified as
"discouraged", being on their way out of the labour market, while the majority of
the study group was healthy job seekers. Work identity seemed to be wage earning 
for 83%, homemaking for 9%, cultural work for 3%, and being a pensioner for 5%.
The main unemployment problem was lack of work for 46% of the examined. Other
problems were poor health, being less attractive workers, or having little
courage for job search. The evaluations predicted re-employment after two years. 
They divided the unemployed in groups with from five to seven times difference in
re-employment rate. CONCLUSION--These standardized sociomedical evaluations seen 
to be useful in clinical work with unemployed people.

PMID: 8146506 [PubMed - indexed for MEDLINE]


49. Br J Ind Med. 1993 May;50(5):450-9.

Mortality and incidence of cancer in a cohort of Swedish chimney sweeps: an
extended follow up study.

Evanoff BA, Gustavsson P, Hogstedt C.

Division of Occupational Medicine, National Institute of Occupational Health,
Solna, Sweden.

Despite 200 years of efforts to regulate safety in this occupation, chimney
sweeps have increased mortality from cancer, ischaemic heart disease, and
respiratory disease. Mortality and incidence of cancer were examined in a cohort 
of 5542 Swedish chimney sweeps employed through their national trade union at any
time between 1918 and 1980. Previous studies of this cohort found increased risks
of ischaemic heart disease, respiratory disease, accidental deaths, and various
neoplasms. By increasing follow up, we sought to increase the power of the study 
and examine disease time trends. Mortality analysis was extended 7.5 years to
cover the period 1951-90; cancer incidence analysis was extended six years to
cover the period 1958-87. New findings include increased incidence and mortality 
of prostate cancer (SMR 169, 95% CI 106-256, 22 observed) and increased incidence
of total haematolymphatic cancers (SIR 151, 95% CI 106-209, 36 observed). When
only the most recent follow up period was analysed, previously observed risks
persisted for total lung cancer (SIR 178, 95% CI 99-293), oat cell lung cancer
(SIR 240, 95% CI 103-472), bladder cancer (SIR 247, 95% CI 131-422), and
oesophageal cancer (Obs/Exp = 2/1.1). Mortality from ischaemic heart disease (SMR
98, 95% CI 76-123) and respiratory disease (SMR 111, 95% CI 56-199) declined
during recent follow up, although significant excess mortality remained during
analysis of the entire study period (ischaemic heart disease SMR 128, 95% CI
112-145; respiratory disease SMR 159, 95% CI 115-213). In analyses of the entire 
study period, risks of ischaemic heart disease and lung, bladder, and oesophageal
cancer were adjusted for smoking; oesophageal cancer was also adjusted for use of
alcohol. All risks remained significantly raised. Exposure-response analyses
showed significant positive associations between duration of employment and risks
for mortality from lung, oesophageal, and total cancer. Chimney sweeps remain at 
increased risk for cancers of the lung, oesophagus, and bladder. Our study
supports a casual role for exposure to chimney soot, which contains carcinogens
including polycyclic aromatic hydrocarbons. Extended follow up of this cohort now
shows increased risks of prostate and haematolymphatic cancers.

PMCID: PMC1012164
PMID: 8507598 [PubMed - indexed for MEDLINE]


50. East Afr Med J. 1992 Feb;69(2):55-7.

Unusual form of motor neuron disease in Kenya.

Adam AM.

Department of Medicine, College of Health Sciences, University of Nairobi, Kenya.

Comment in:
    East Afr Med J. 1992 Feb;69(2):53-4.

Over the period November 1978 to October 1988, 46 cases of motor neuron disease
were seen at Kenyatta National Hospital, Nairobi. One case was seen in private
practice. A bimodal age distribution of the disease was identified with a peak in
the fourth decade of life and another peak in the sixth decade of life. The
disease seen in the fourth decade of life was different as seen in other parts of
the world in that the majority of patients tended to present with very rapidly
progressive disease despite the primary presentation with limb symptoms and
signs. Serum cholinesterase activity in five of these patients and five of the
classical motor neuron disease revealed no abnormalities. This unusually rapidly 
progressive disease in young adults has not been described anywhere. The disease 
seen in older age groups and especially in patients over fifty years of age was
not different from the one seen in other parts of the world.

PMID: 1505388 [PubMed - indexed for MEDLINE]


51. Eur J Appl Physiol Occup Physiol. 1991;62(6):436-44.

Zero crossing rate of electromyograms during occupational work and endurance
tests as predictors for work related myalgia in the shoulder/neck region.

Hägg GM, Suurküla J.

Division of Applied Work Physiology, National Institute of Occupational Health,
Solna, Sweden.

The relationship between electromyographic signs of fatigue (ESF) during work and
occupation-related myalgia in the shoulder/neck region was investigated in a
longitudinal study. Forty-three healthy female assembly workers were studied over
2 years. Measurements were performed at the start of the study with follow-up
measurements after 1 and 2 years. The ESF were estimated as the zero crossing
rate of electromyograms (EMG) detected during short test contractions performed
during short breaks in normal work. As a complement, an endurance test using EMG 
records was performed and analysed with the zero crossing technique. The
occurrence of shoulder/neck disorders was assessed by a clinical investigation
and a questionnaire. No significant relationship between ESF during work in year 
0 and deterioration of the disorder was seen. On the other hand, the absolute
zero crossing rate and the time constant of the zero crossing decline from the
endurance test showed a significant relationship with deterioration of the
disorder. The ESF during work year 2, showed a significant relationship with
disorder year 2, while the endurance test parameters year 2 did not. It was
concluded that ESF during work was not a predictor of muscle injury, whereas it
could be useful as a diagnostic tool.

PMID: 1893908 [PubMed - indexed for MEDLINE]


52. Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1450-6.

The effect of physical activity during pregnancy on preterm delivery and birth
weight.

Klebanoff MA, Shiono PH, Carey JC.

Division of Prevention Research, National Institute of Child Health and Human
Development, National Institutes of Health, Bethesda, MD 20892.

The relationship between physical activity during pregnancy, preterm birth, and
gestational age-adjusted birth weight was investigated prospectively in a cohort 
of 7101 women. This study is one of few to evaluate both employment- and
non-employment-related physical activity. Prolonged periods of standing were
associated with a modestly increased risk of preterm delivery (adjusted odds
ratio for greater than or equal to 8 hours/day of standing = 1.31). Heavy work or
exercise was not associated with preterm delivery (adjusted odds ratio for
greater than or equal to 4 hours per day of heavy work = 1.04). The proportion of
infants born preterm did not differ among women working in predominantly
standing, active, and sedentary occupations. Physical activity was not associated
with gestational age-adjusted birth weight after controlling for confounding
variables. These data suggest that unmeasured socioeconomic differences among
women reporting different levels of activity may account for previously described
associations between physical activity and pregnancy outcome. Most pregnant women
who report increased levels of physical activity are not at increased risk of
preterm delivery or reduced intrauterine growth. However, these data do not
address the role of activity restriction in the management of selected women at
high risk for adverse pregnancy outcome.

PMID: 2240086 [PubMed - indexed for MEDLINE]


53. Am J Epidemiol. 1990 Aug;132(2):293-303.

Incidence of leukemia in occupations with potential electromagnetic field
exposure in United States Navy personnel.

Garland FC, Shaw E, Gorham ED, Garland CF, White MR, Sinsheimer PJ.

Naval Health Research Center, San Diego, CA 92186-5122.

Leukemia is the fourth most commonly occurring cancer in the United States
population between the ages of 17 and 34 years, an age group heavily represented 
in the US Navy. Historical computerized military career records maintained at the
Naval Health Research Center, San Diego, California, were used to determine
person-years at risk (total, 4,072,502 person-years) by demographic
characteristics and occupation for active-duty naval personnel during 1974-1984. 
Computerized inpatient medical records were searched for first hospitalizations
for leukemia. Cases of leukemia (n = 102) were verified by using pathology
reports or Navy Medical Board or Physical Evaluation Board findings. For
comparisons, age-adjusted incidence rates and standardized incidence ratios were 
calculated by using rates for the US population provided by the Surveillance,
Epidemiology, and End Results program of the National Cancer Institute. The
overall age-adjusted incidence rate of leukemia in active-duty naval personnel
was found to be very close to that of the Surveillance, Epidemiology, and End
Results program population (6.0 vs. 6.5 per 100,000 person-years). Only one
occupation, electrician's mate, emerged with a borderline statistically
significant excess risk of leukemia (standardized incidence ratio compared with
the Surveillance, Epidemiology, and End Results program population = 2.4, 95%
confidence interval 1.0-5.0). This finding is intriguing in the light of several 
studies showing an excess risk of leukemia associated with exposure to
electromagnetic fields.

PMID: 2372008 [PubMed - indexed for MEDLINE]


54. Sex Roles. 1981 Jan;7(1):35-47.

Family timing in late adolescence and early adulthood: the case of southern
males.

Marshall KP, Zito GV, Cosby AG.

PIP: A model of processes underlying marriage and family timing were applied to
longitudinal data on 288 young adult males from the Southern Youth Study. The
purpose was to assess the implications which adolescent status and familial
orientations may hold for patterns of family formation and expansion. The
subjects were selected from nonmetropolitan high schools in Alabama, Georgia,
Texas, and South Carolina. Initial contact was made in the sophomore year
(1966-1967) when family background and significant other encouragement data were 
requested through questionnaires administered in the classroom. Recontacted as
seniors in 1968, respondents were questioned concerning status and family
aspirations. In 1972 the respondents were contacted for a 3rd time and data
regarding marriage timing and procreation were obtained. 45% of the 288 males had
married within 4 years of high school, but 81% reported no children. 16% reported
1 child and only 3% reported 2 or more children. On the average, as high school
seniors, these males expressed desires for slightly later marriage than did males
in the Project Talent national study of high school seniors. The expected
negative relationships of early fertility with significant other occupational
encouragement and with educational aspirations indicated high aspirations to be
associated with lower young adult procreation. The strongest correlation
reflected the importance of marital timing. Premarital factors failed to directly
influence procreation independently of marital duration and only adolescent
educational and marital desires directly influenced the timing of marriage.

PMID: 12310209 [PubMed - indexed for MEDLINE]

1. Soc Sci Med. 2009 Jan;68(1):49-59. Epub 2008 Nov 17.

A multi-group cross-lagged analyses of work stressors and health using Canadian
National sample.

Ibrahim S, Smith P, Muntaner C.

Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, Canada 
M5G 2E9. sibrahim@iwh.on.ca

This article examines the reciprocal relationships between work variables and
health outcomes and if these relationships differ by social class (measured by
occupational grouping). We used longitudinal data from the 1994/95--2002/03
Canadian National Population Health Survey (NPHS). Karasek's work stress
variables were measured in the 1994/95 (cycle 1, time 1), 2000/01 (cycle 4, time 
2) and 2002/03 (cycle 5, time 3) surveys. Analyses were limited to 2556
respondents aged 18-56 at time 1 and who remained in the same social class (as
defined by occupational position) for all the three time points. Work variables
used were job strain ratio, work social support and job insecurity. Health
outcomes used were distress, depression and self-rated health. Multi-group path
analyses were used to investigate the reciprocal relationships between work and
health variables and if these relationships differed by social class. Analyses
controlled for age, gender, marital status and work status. We find there is a
differential burden of work psychosocial factors and health outcomes by social
class. The cross-lagged relationships between work and health depended on the
outcome, social class and time lag. More significant paths from work to health
were observed than reverse paths from health to work. More significant
relationships between work and health were observed for the shorter time lag (2
years) compared to longer time lags (6 years). Low work social support and job
insecurity were more detrimental to health for respondents in lower social class 
positions. Findings from this study highlight the importance of time lag, and to 
some extent social class, in the reciprocal relationships between work and
health.

PMID: 19010577 [PubMed - indexed for MEDLINE]


2. Int J Tuberc Lung Dis. 2008 Oct;12(10):1160-5.

Factors contributing to treatment success among tuberculosis patients: a
prospective cohort study in Bangkok.

Okanurak K, Kitayaporn D, Akarasewi P.

Department of Social and Environmental Medicine, Faculty of Tropical Medicine,
Mahidol University, Bangkok, Thailand. tmkok@mahidol.ac.th

SETTING: Chest Clinic, Ministry of Public Health and health care centres, Bangkok
Metropolitan Administration. OBJECTIVE: To determine patient factors predicting
successful tuberculosis (TB) treatment. DESIGN: A prospective cohort was
conducted during May 2004 to November 2005. Newly diagnosed TB patients aged > or
= 15 years were recruited after giving informed consent. Three sets of
questionnaires were used to collect data from the patients three times. Data were
also gathered from treatment cards. RESULTS: Of 1241 patients, 81.1% were
successfully treated. Bivariate analysis indicated that patients' sex, education,
occupation, level of knowledge about TB and adverse effects were associated with 
treatment success. Unconditional logistic regression analysis showed that females
had a higher success rate than males (OR = 1.9, 95%CI 1.2-2.9). Patients with
regular incomes had twice the likelihood of success of the unemployed (OR = 2.0, 
95%CI 1.1-3.5). Patients with high knowledge levels were more likely to complete 
treatment (OR = 2.0, 95%CI 1.2-3.4), while those with adverse effects were less
likely to adhere (OR = 0.6, 95%CI 0.4-0.9). CONCLUSION: The current low treatment
success rate may be partly due to inadequate knowledge about TB among patients.
Improvements in health education and early detection and management of adverse
effects should be prioritised by the National Tuberculosis Programme.

PMID: 18812046 [PubMed - indexed for MEDLINE]


3. Occup Environ Med. 2009 Mar;66(3):150-3. Epub 2008 Sep 19.

Socio-economic differences in the association between sickness absence and
mortality: the prospective DREAM study of Danish private sector employees.

Lund T, Kivimäki M, Christensen KB, Labriola M.

Danish National Centre for Social Research, Herluf Trolles Gade 11, Copenhagen,
Denmark. tlu@sfi.dk

OBJECTIVES: To examine duration of sickness absence as a risk marker for future
mortality by socio-economic position among all private sector employees in
Denmark in 1998-2004. METHODS: All residents in Denmark employed in the private
sector receiving sickness absence compensation in 1998 were investigated in a
prospective cohort study. 236 207 persons (38.2% women, 61.8% men, age range
18-65, mean age 37.8 years) alive on 1 January 2001 were included in the study.
Mortality from 1 January 2001 to 31 December 2004 was assessed using national
register data. Deaths in 1999 and 2000 were excluded to determine the status of
sickness absence duration as an early risk marker. For analyses within
occupational grades, data were available for a sub-population of 137 607 study
participants. RESULTS: 3040 persons died during follow-up. The age-adjusted risk 
of future mortality increased by duration of sickness absence in a graded fashion
among men and non-blue collar workers. Among women and blue collar workers, there
was no association of mortality with duration of sickness absences below 6 weeks.
However, employees with > or =6 weeks of absence compared to those with 1-week
absence had a substantial excess risk of death in all groups: adjusted hazard
ratio 2.2 (95% CI 1.8 to 2.7) for women, 2.1 (95% CI 1.8 to 2.4) for men, 3.7
(95% CI 1.9 to 7.2) in white collar occupations, 3.3 (95% CI 2.2 to 5.0) in
intermediate grade occupations and 2.0 (95% CI 1.7 to 2.3) in blue collar
occupations. CONCLUSION: Administratively collected data on sickness absence
compensation for periods > or =6 weeks identified "at risk" groups for future
excess mortality in male and female private sector employees across occupational 
grade levels.

PMID: 18805885 [PubMed - indexed for MEDLINE]


4. Health Econ. 2009 May;18(5):535-48.

Weight and wages: fat versus lean paychecks.

Han E, Norton EC, Stearns SC.

Institute for Health Research and Policy, University of Illinois at Chicago,
Chicago, IL 60608, USA. eunahan@uic.edu

Past empirical work has shown a negative relationship between the body mass index
(BMI) and wages in most cases. We improve on this work by allowing the marginal
effect of non-linear BMI groups to vary by gender, age, and type of interpersonal
relationships required in each occupation. We use the National Longitudinal
Survey of Youth 1979 (1982-1998). We find that the often-reported negative
relationship between the BMI and wages is larger in occupations requiring
interpersonal skills with presumably more social interactions. Also, the wage
penalty increases as the respondents get older beyond their mid-twenties. We show
that being overweight and obese penalizes the probability of employment across
all race-gender subgroups except black women and men. Our results for the
obesity-wage association can be explained by either consumers or employers having
distaste for obese workers. (c) 2008 John Wiley & Sons, Ltd.

PMID: 18677723 [PubMed - indexed for MEDLINE]


5. Ann Epidemiol. 2007 Aug;17(8):608-14. Epub 2007 May 23.

Socioeconomic position in childhood and adulthood and weight gain over 34 years: 
the Alameda County Study.

Baltrus PT, Everson-Rose SA, Lynch JW, Raghunathan TE, Kaplan GA.

National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA, USA.
pbaltrus@msm.edu

PURPOSE: Socioeconomic position (SEP) has been shown to be related to obesity and
weight gain, especially among women. It is unclear how different measures of
socioeconomic position may impact weight gain over long periods of time, and
whether the effect of different measures vary by gender and age group. We
examined the effect of childhood socioeconomic position, education, occupation,
and log household income on a measure of weight gain using individual growth
mixed regression models and Alameda County Study data collected over thirty four 
years(1965-1999). METHODS: Analyses were performed in four groups stratified by
gender and age at baseline: women, 17-30 years (n = 945) and 31-40 years (n =
712); men, 17-30 years (n = 766) and 31-40 years (n = 608). RESULTS: Low
childhood SEP was associated with increased weight gain among women 17-30 (0.13
kg/year, p < 0.001). Low educational status was associated with increased weight 
gain among women 17-30 (0.14 kg/year, p = 0.030), 31-40 (0.14 kg/year, p =
0.014), and men 17-30 (0.20 kg/year, p = 0.001). CONCLUSION: Log household income
was inversely associated with weight gain among men 31-40 (-0.10 kg/yr, p =
0.16). Long-term weight gain in adulthood is associated with childhood SEP and
education in women and education and income in men.

PMID: 17521922 [PubMed - indexed for MEDLINE]


6. Health Rep. 2006 Oct;17(4):11-29.

Stress and depression in the employed population.

Shields M.

Health Statistics Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
Margot.Shields@statcan.ca

OBJECTIVES: This article describes stress levels among the employed population
aged 18 to 75 and examines associations between stress and depression. DATA
SOURCES: Data are from the 2002 Canadian Community Health Survey: Mental Health
and Well-being and the longitudinal component of the 1994/95 through 2002/03
National Population Health Survey. ANALYTICAL TECHNIQUES: Stress levels were
calculated by sex, age and employment characteristics. Multivariate analyses were
used to examine associations between stress and depression in 2002, and between
stress and incident depression over a two-year period, while controlling for age,
employment characteristics, and factors originating outside the workplace. MAIN
RESULTS: In 2002, women reported higher levels of job strain and general
day-to-day stress. When the various sources of stress were considered
simultaneously, along with other possible confounders, for both sexes, high
levels of general day-to-day stress and low levels of co-worker support were
associated with higher odds of depression, as was high job strain for men. Over a
two-year period, men with high strain jobs and women with high personal stress
and low co-worker support had elevated odds of incident depression.

PMID: 17111591 [PubMed - indexed for MEDLINE]


7. Am J Ind Med. 2006 Dec;49(12):997-1004.

Twenty-three years of hypersensitivity pneumonitis mortality surveillance in the 
United States.

Bang KM, Weissman DN, Pinheiro GA, Antao VC, Wood JM, Syamlal G.

National Institute for Occupational Safety and Health, Centers for Disease
Control and Prevention, Morgantown, West Virginia 26505, USA. kmb2@cdc.gov

BACKGROUND: There are few population-based studies addressing hypersensitivity
pneumonitis (HP) in the United States. The National Institute for Occupational
Safety and Health (NIOSH) has nationally comprehensive longitudinal mortality
data that can contribute to a better understanding of the epidemiology of HP.
METHODS: The National Center for Health Statistics multiple cause-of-death data
were analyzed for the period 1980-2002. Annual death rate was age-adjusted to the
2000 U.S. standard population. Death rate time-trends were calculated using a
linear regression model and geographic distribution of death rates were mapped by
state and county. Proportionate mortality ratios (PMRs) by usual industry and
occupation adjusted for age, sex, and race, were based on data from 26 states
reporting industry and occupation during 1985-1999. RESULTS: Overall age-adjusted
death rates increased significantly (P < 0.0001) between 1980 and 2002, from 0.09
to 0.29 per million. Wisconsin had the highest rate at 1.04 per million. Among
industries, PMR for HP was significantly high for agricultural production,
livestock (PMR, 19.3; 95% CI, 14.0-25.9) and agricultural production, crops (PMR,
4.3; 95% CI, 3.0-6.0). Among occupations, PMR for HP was significantly elevated
for farmers, except horticulture (PMR, 8.1; 95% CI, 6.4-10.2). CONCLUSIONS: These
findings indicate that agricultural industries are closely associated with HP
mortality and preventive strategies are needed to protect workers in these
industries.

PMID: 17096370 [PubMed - indexed for MEDLINE]


8. Arch Dermatol. 2006 Mar;142(3):305-11.

Prognosis of occupational hand eczema: a follow-up study.

Cvetkovski RS, Zachariae R, Jensen H, Olsen J, Johansen JD, Agner T.

Department of Dermatology, Gentofte Hospital, University of Copenhagen, Hellerup,
Denmark.

Comment in:
    Arch Dermatol. 2006 Mar;142(3):362-4.

OBJECTIVE: To identify prognostic risk factors in patients with occupational hand
eczema (OHE). DESIGN: Cohort study with 1-year follow-up. SETTING: Danish
National Board of Industrial Injuries Registry. PATIENTS: All patients with newly
recognized OHE (758 cases) from October 1, 2001, through November 10, 2002.
INTERVENTIONS: Participants received a questionnaire covering self-rated
severity, sick leave, loss of job, depression, and health-related quality of
life. One year after the questionnaire was returned, all responders (N = 621)
received a follow-up questionnaire, and 564 (91%) returned it. MAIN OUTCOME
MEASURES: Persistently severe or aggravated OHE, prolonged sick leave, and loss
of job after 1-year follow-up. RESULTS: During the follow-up period, 25% of all
patients with OHE had persistently severe or aggravated disease, 41% improved,
and 34% had unchanged minimal or mild to moderate disease. Patients with atopic
dermatitis fared poorly compared with other patients. Patients younger than 25
years fared clearly better than older groups. Furthermore, severe OHE, age 40
years or greater, and severe impairment of quality of life at baseline appeared
to be important predictors of prolonged sick leave and unemployment. Patients
with lower socioeconomic status also had a high risk of prolonged sick leave, job
change, and loss of job. Contact allergy was not found to be a risk factor for
poor prognosis. CONCLUSIONS: Atopic dermatitis, greater age, and low
socioeconomic status may be reliable prognostic factors in early OHE. Quality of 
life and standardized severity assessment may also be valuable tools to identify 
patients at high risk of prolonged sick leave and unemployment.

PMID: 16549705 [PubMed - indexed for MEDLINE]


9. Southeast Asian J Trop Med Public Health. 2005 Jul;36(4):822-31.

Surveillance of imported bancroftian filariasis after two-year multiple-dose
diethylcarbamazine treatment.

Koyadun S, Bhumiratana A.

Office of Disease Prevention and Control 11, Nakhon Si Thammarat, Department of
Disease Control, Ministry of Public Health, Nakhon Si Thammarat, Thailand.

Myanmar migrants are at increased risk for nocturnally periodic Wuchereria
bancrofti causing imported bancroftian filariasis. They have a significant
influence on the effectiveness of diethylcarbamazine (DEC) mass treatment at the 
provincial level in the National Program to Eliminate Lymphatic Filariasis (PELF)
during the fiscal years (FY) 2002-2006, in Thailand. Two oral doses of DEC 6
mg/kg are given twice a year to the eligible Myanmar migrants (> or = 2 years
old). A 300 mg DEC provocation test is given once a year to all Myanmar migrants 
with work permits. Effectiveness evaluation parameters, such as cumulative index 
(CI) and the effectiveness ratio (ER), were obtained after 2 years of the
multiple-dose DEC treatment program in Ranong Province, Southern Thailand. By
cross-sectional night blood surveys at the end of FY 2003 in two districts of
Ranong Province, the microfilarial positive rates (MPR) were 0.8% and 1.2% for
Mueang Ranong and Kra Buri, respectively. The MPR in the agricultural (1.5%) and 
industrial (0.4%) occupations were not significantly different from each other.
Our findings suggest that most untreated microfilaremics working in agriculture, 
with short-term residency in Thailand, may have delayed multiple-dose DEC
treatment.

PMID: 16295532 [PubMed - indexed for MEDLINE]


10. Food Nutr Bull. 2005 Jun;26(2 Suppl 1):S25-45.

Social and economic development and change in four Guatemalan villages:
demographics, schooling, occupation, and assets.

Maluccio JA, Melgar P, Méndez H, Murphy A, Yount KM.

Department of Global Health, Rollins School of Public Health, Emory University,
Atlanta, GA 20006, USA. J.Maluccio@cgiar.org

This article uses census data and village histories to examine changes over the
last 35 years in the four villages where the Institute of Nutrition of Central
America and Panama (INCAP) Longitudinal Study (1969-77) was conducted and offers 
a rare picture of development and change in rural localities over a long period
of time. In addition, by characterizing the environment in which the subjects of 
this study were raised, we provide context for and inputs into quantitative
analyses of data collected at various points in time on these subjects. The
villages have undergone massive demographic, social, and economic change. Initial
differences have conditioned many of these changes, especially differences
associated with agricultural potential and location. Originally these villages
were rather isolated, but road and transportation access has improved
substantially. The populations in the villages have more than doubled and also
have aged. While marriage patterns have held steady, religious practice has
changed a great deal. After many years of steady out-migration, three of the four
villages are more recently experiencing net in-migration, a pattern associated
with ease of access. Schooling access and outcomes also have improved, with
average grades of schooling nearly tripling and literacy doubling to levels
currently above national averages. Although agriculture remains an important
component of individual livelihood strategies, non-agricultural sources of
employment have become more important. Much of this change is associated with
declining agricultural markets and increased access to non-agricultural jobs near
the villages and in the capital. Accompanying these changes has been an
improvement in living standards as measured by a number of indicators of
household living conditions and consumer durable goods.

PMID: 16060210 [PubMed - indexed for MEDLINE]


11. Scand J Work Environ Health. 2004 Oct;30(5):362-70.

Central nervous system effects of acute organophosphate poisoning in a two-year
follow-up.

Delgado E, McConnell R, Miranda J, Keifer M, Lundberg I, Partanen T, Wesseling C.

Department of Preventive Medicine, Occupational Health Program, National
Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua.

OBJECTIVES: Patients hospitalized for acute organophosphate poisoning in León,
Nicaragua, were followed for effects on the central nervous system (CNS) over a
2-year period. METHODS: Immediate verbal memory (Rey verbal learning), visuomotor
performance (digit symbol), and neuropsychiatric symptoms (Q-16) were assessed
for 53 poisoned persons at the time of hospital discharge, 7 weeks postpoisoning,
and 2 years postpoisoning, and, at the same time intervals, for 28 persons who
had never been poisoned. The poisonings were classified as moderate occupational 
(31), severe occupational (15), and severe through the oral route (7),
representing low, medium, and high exposure, respectively. Longitudinal
confounder-adjusted between-category comparisons and longitudinal analyses of
variance and covariance were used to assess the effects of the exposure. RESULTS 
:Immediate verbal learning showed deficits in the high-exposure group, in
particular at the time of discharge, but the estimate of the difference when
compared with the values of the unexposed was imprecise. Visuomotor performance
showed a deficit at 7 weeks in the medium-exposure group, but it had improved
after 2 years relative to that of the unexposed, for whom improvement had
occurred at 7 weeks and persisted during the 2 years of follow-up, possibly a
test-retest effect. Neuropsychiatric symptoms were in excess 2 years after the
hospital discharge in the low- and medium-exposure groups and all the groups
combined. All the results were imprecise for the small high-exposure group.
CONCLUSIONS: Visuomotor performance and possibly short-term verbal memory seem to
be affected early after severe acute organophosphate poisoning and recover,
either truly or by some compensatory mechanism. Neuropsychiatric symptoms seem to
increase after a longer latency period.

PMID: 15529800 [PubMed - indexed for MEDLINE]


12. Sex Transm Dis. 2004 Sep;31(9):533-41.

Family socioeconomic status and self-reported sexually transmitted diseases among
black and white american adolescents.

Newbern EC, Miller WC, Schoenbach VJ, Kaufman JS.

Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel
Hill, North Carolina 27599-7435, USA.

OBJECTIVE: The objective of this study was to assess associations between
socioeconomic status (SES) and adolescent sexually transmitted diseases (STDs)
stratified by race and gender. STUDY: In cross-sectional analyses of the National
Longitudinal Study of Adolescent Health Wave One (1995), unadjusted and adjusted 
associations between 4 family SES indicators and STD reports for black and white 
7th through 12th graders were examined. RESULTS: Lower maternal education and
nonprofessional maternal occupations were associated with higher STD reports in
all groups except white females. Generally, STD reports were higher for
adolescents not living in 2-parent homes, and lower income was only associated
for black males. CONCLUSION: Overall, SES is only a weak to moderate marker for
adolescent STD risks. The relationship of SES and STDs varies by the SES measure 
used and differs across race-gender groups. Other individual factors such as risk
behaviors or community factors such as income inequality could play a more
critical role for adolescent STDs than family SES.

PMID: 15480114 [PubMed - indexed for MEDLINE]


13. Transplantation. 2003 Dec 27;76(12):1699-704.

Quality of life in adult survivors beyond 10 years after liver, kidney, and heart
transplantation.

Karam VH, Gasquet I, Delvart V, Hiesse C, Dorent R, Danet C, Samuel D,
Charpentier B, Gandjbakhch I, Bismuth H, Castaing D.

Centre Hépato Biliaire, Hôpital Paul Brousse, 4 Avenue Paul Vaillant-Couturier,
94804 Villejuif Cedex, France. vincent.karam@pbr.ap-hop-paris.fr

BACKGROUND: The yearly increasing survival rates testify to the success of
transplantation, but questions remain relating to the quality of life (QOL)
associated with long-term survival. METHODS: A sample of 126 liver recipients
(Liver-R), 229 kidney recipients (Kidney-R), and 113 heart recipients (Heart-R)
with more than 10 years posttransplant follow-up were included in the study with 
a response rate of 86%. Respondents were matched with healthy subjects recruited 
from general population (GP). The three groups of recipients and GP subjects
completed a French version of the questionnaire used by the National Institute of
Diabetes and Digestive and Kidney Disease, Pittsburgh, PA, and were compared for 
each score, with adjustments for age and sex. RESULTS: Personal function and
measures of disease by the transplant recipients were significantly worse than in
the GP (P<0.0001), with the worst score in Kidney-R. No difference, either
between organs or between organs and GP, was found regarding the perceived social
and role function. However, for psychologic status and general health perception,
Kidney-R had the least favorable performance when compared with GP (P<0.01) and
also when compared with Liver-R (P<0.05). With the exception of Kidney-R, the
well-being index of Liver-R and Heart-R was significantly better than the GP
(P<0.001 and P<0.05, respectively). CONCLUSIONS: The QOL beyond 10 years after
liver, heart, and kidney transplantation is quite similar to the GP, with
Kidney-R starting out as the worst, Heart-R as intermediate, and Liver-R the
best.

PMID: 14688519 [PubMed - indexed for MEDLINE]


14. Am J Public Health. 2003 Jun;93(6):994-8.

Cigarette smoking and cognitive decline in midlife: evidence from a prospective
birth cohort study.

Richards M, Jarvis MJ, Thompson N, Wadsworth ME.

Medical Research Council, National Survey of Health and Development, University
College London, London, England. m.richards@ucl.ac.uk

OBJECTIVES: The authors investigated the effects of cigarette smoking on midlife 
cognitive performance. METHODS: Multiple regression was used to test the
association between cigarette smoking and changes in cognitive test scores among 
male and female members of the British 1946 birth cohort aged between 43 and 53
years. RESULTS: Smoking was associated with faster declines in verbal memory and 
with slower visual search speeds. These effects were largely accounted for by
individuals who smoked more than 20 cigarettes per day and were independent of
sex, socioeconomic status, previous (adolescent) cognitive ability, and a range
of health indicators. CONCLUSIONS: The present results show that heavy smoking is
associated with cognitive impairment and decline in midlife. Smokers who survive 
into later life may be at risk of clinically significant cognitive declines.

PMCID: PMC1447882
PMID: 12773367 [PubMed - indexed for MEDLINE]


15. Am J Psychiatry. 2003 May;160(5):939-46.

Family disruption in childhood and risk of adult depression.

Gilman SE, Kawachi I, Fitzmaurice GM, Buka SL.

Department of Maternal and Child Health, Harvard School of Public Health, 677
Huntington Avenue, Boston, MA 02115, USA. sgilman@hsph.harvard.edu

OBJECTIVE: The authors examined the risk that family disruption and low
socioeconomic status in early childhood confer on the onset of major depression
in adulthood. METHOD: Participants were 1,104 offspring of mothers enrolled
during pregnancy in the Providence, R.I., site of the National Collaborative
Perinatal Project. Measures of childhood family disruption and socioeconomic
status were obtained before birth and at age 7. Structured diagnostic interviews 
were used to assess respondents' lifetime history of major depressive episode
between the ages of 18 and 39. Survival analysis was used to identify childhood
risks for depression onset. RESULTS: Parental divorce in early childhood was
associated with a higher lifetime risk of depression among subjects whose mothers
did not remarry as well as among subjects whose mothers remarried. These effects 
were more pronounced when accompanied by high levels of parental conflict.
Independent of the respondents' adult socioeconomic status, low socioeconomic
status in childhood predicted an elevated risk of depression. CONCLUSIONS: Family
disruption and low socioeconomic status in early childhood increase the long-term
risk for major depression. Reducing childhood disadvantages may be one avenue for
prevention of depression. Identification of modifiable pathways linking aspects
of the early childhood environment to adult mental health is needed to mitigate
the long-term consequences of childhood disadvantage.

PMID: 12727699 [PubMed - indexed for MEDLINE]


16. Bull Soc Pathol Exot. 2002 Aug;95(3):167-71.

[Epidemiology of snake bites in the Republic of Ivory Coast]

[Article in French]

Chippaux JP.

Institut de recherche pour le développement (IRD), B. P. 1 386, Dakar, Sénégal.
chippaux@ird.sn

A national survey was carried out in Côte d'Ivoire in 1979 in order to evaluate
the incidence, morbidity and mortality of snakebites. This unpublished survey has
not been renewed to our knowledge. Although 20 odd years have passed since, the
survey is not obsolete and can be usefully presented at this congress. We
associated a retrospective survey using health centre registers and a prospective
survey performed in 7 health centres between 1972 and 1979. The incidence,
estimated prospectively for rural areas, exceeded 200 bites for 100,000
inhabitants. This evaluation could be an underestimation because many victims
consulted traditional practitioners. Annual morbidity was higher in forest areas 
(195 envenomations per 100,000 inhabitants) than in the savannah (130
envenomations per 100,000 inhabitants). Conversely, the case fatality rate was
higher in the savannah (3.1%) than in forest areas (2%). More than half of the
bites involved men aged 15 to 50 years. The risks were significantly higher for
farmers, particularly in industrial plantations, where 27% of the total of number
of bites involved 1.5% of the population. At the beginning of the 1980s,
envenomations could be estimated at over 13,000 per 8 million inhabitants and the
number of deaths 200 per annum.

PMID: 12404862 [PubMed - indexed for MEDLINE]


17. Int J Obes Relat Metab Disord. 2000 Dec;24(12):1642-7.

Determinants of overweight tracking from childhood to adolescence: a 5 y
follow-up study of Hat Yai schoolchildren.

Mo-suwan L, Tongkumchum P, Puetpaiboon A.

Department of Pediatrics, Faculty of Medicine, Prince of Songkhla University,
Thailand. mladda@ratree.psu.ac.th

OBJECTIVE: To study the determinants of overweight tracking from childhood to
adolescence of Hat Yai schoolchildren. DESIGN: A longitudinal study. SETTING:
Primary and secondary schools of Hat Yai municipality, southern Thailand.
SUBJECTS: 2252 schoolchildren recruited in 1992 and follow-up for 5y.
MEASUREMENTS: Child's annual body mass index (BMI, kg/m2) from 1992 to 1997;
parental BMIs, parental income, and family history of diseases by a questionnaire
completed by parents in 1992. RESULTS: Prevalence of overweight of males using
the 85th percentile of the U S First National Health and Nutritional Examination 
Survey reference for age and sex as a cut-off point increased from 12.4% in 1992 
to 21% in 1997, whereas that of females went down from 15.2 to 12.6. At the end
of the fifth year, 11.8% of children remained overweight while 4.5% became
overweight. Comparing to the non-overweights, the risk for becoming an overweight
adolescent of an overweight boy was 8.2 (95% confidence interval (CI) = 6, 11.2) 
whereas that of the overweight girls was 20 (95% CI = 12.4, 32.3). The
generalized estimating equations model predicted an increase in child BMI
associated with having a father or a mother with high BMI, a family history of
obesity, a monthly income greater than 5000 baht, and a lower level of exercise
than their peers. Secular increase in BMI was also observed. CONCLUSION:
Predictors of overweight tracking found in this study would be useful to select
children at risk for preventive intervention.

PMID: 11126218 [PubMed - indexed for MEDLINE]


18. Soc Sci Med. 1998 Dec;47(12):2043-53.

Social class, assets, organizational control and the prevalence of common groups 
of psychiatric disorders.

Muntaner C, Eaton WW, Diala C, Kessler RC, Sorlie PD.

Institute of Occupational and Environmental Health and Prevention Research
Center, West Virginia University, Morgantown 26506-9190, USA.

This study provides an update on the association between social class and common 
types of psychiatric disorder in the US. In addition to usual measures of social 
class, we provide hypotheses for the expectation that assets and organizational
control are associated with specific varieties of psychiatric disorders (mood,
anxiety, alcohol and drug use disorders). We analyzed two surveys. The National
Comorbidity Survey conducted in 1990-1992 yielded 12-month prevalence rates in a 
probability sample of 8098 respondents in the 48 contiguous states. The
Epidemiologic Catchment Area Follow-up conducted in 1993-1996 provided similar
rates among 1920 East Baltimore residents. Analyses of the National Comorbidity
Survey showed an inverse association between financial and physical assets and
mood, anxiety, alcohol, and drug disorders. The Epidemiologic Catchment Area
Followup provided additional evidence for the inverse association between
financial and physical assets and anxiety, alcohol and drug disorders. Also in
the Epidemiologic Catchment Area, lower level supervisors presented higher rates 
of depression and anxiety disorders than higher level managers. Inequalities in
assets and organizational control, as well as typical measures of social class,
are associated with specific psychiatric disorders. These constructs can provide 
additional explanations for why social inequalities in psychiatric disorders
occur.

PMID: 10075245 [PubMed - indexed for MEDLINE]


19. Am J Prev Med. 1998 Nov;15(4):344-61.

Worksite physical activity interventions.

Dishman RK, Oldenburg B, O'Neal H, Shephard RJ.

Department of Exercise Science, University of Georgia, Athens 30602-6554, USA.

BACKGROUND: National objectives for public health have targeted worksite as
important settings for interventions to increase physical activity. However,
expert reviews reveal no scientific consensus about the effectiveness of worksite
interventions for increasing physical activity or fitness. METHODS: We judged the
quantity and quality of existing evidence against scientific standards for the
internal and external validity of the research design and the validity of
measurements. Meta-analytic methods were used to quantify the size of effects
expressed as Pearson correlation coefficients (r). Variation in effect was
examined in relation to several features of the studies deemed important for
implementing successful worksite interventions. Pre-experimental cohort studies
were excluded because they are sensitive to secular trends in physical activity. 
RESULTS: Twenty-six studies involving nearly 9,000 subjects yielded 45 effects.
The mean effect was heterogeneous and small, r = 0.11 (95% CI, -0.20 to 0.40),
approximating 1/4 S.D., or an increase in binomial success rate from 50% to 56%. 
Although effects varied slightly according to some of the study features we
examined, effects were heterogeneous within levels of these features. Hence, the 
moderating variables examined did not explain variation in the effects (P >
0.05). The exception was that effects were smaller in randomized studies compared
with studies using quasi-experimental designs (P < 0.05). CONCLUSIONS: Our
results indicate that the typical worksite intervention has yet to demonstrate a 
statistically significant increase in physical activity or fitness. The few
studies that have used an exemplary sample, research design, and outcome measure 
have also yielded small or no effects. The generally poor scientific quality of
the literature on this topic precludes the judgment that interventions at
worksites cannot increase physical activity or fitness, but such an increase
remains to be demonstrated by studies using valid research designs and measures.

PMID: 9838977 [PubMed - indexed for MEDLINE]


20. Pediatrics. 1998 Aug;102(2):e25.

Parental literacy level and understanding of medical information.

Moon RY, Cheng TL, Patel KM, Baumhaft K, Scheidt PC.

Department of General Pediatrics, Children's Research Institute, Children's
National Medical Center, Washington, DC 20010, USA.

OBJECTIVE: To ascertain the impact of literacy level on parents' understanding of
medical information and ability to follow therapy prescribed for their children. 
DESIGN/METHODS: A prospective cohort of parents accompanying their children for
acute care. Parents were interviewed about demographic status, their child's
health, and use of pediatric preventive services. The Rapid Estimate of Adult
Literacy in Medicine (REALM) test was used to assess parental literacy. The same 
parent was interviewed 48 to 96 hours later and asked to recall the child's
diagnosis, any medication prescribed, and instructions. RESULTS: A total of 633
patients were enrolled. Follow-up was obtained in 543 patients (85.8%). Mean
parental age was 32.43 years (SD = 9.07). Mean REALM score was 57.6 (SD = 10.9), 
corresponding to a 7th- to 8th-grade reading level, with a mean parental
educational level of 13.43 years (SD = 2.09). Low REALM score was significantly
correlated with young parental age and parental education. African-American race 
was associated with lower REALM scores. After controlling for these variables,
REALM score significantly correlated with parental perception of how sick the
child was, but not with use of preventive services, comprehension of diagnosis,
medication name and instructions, or ability to obtain and administer prescribed 
medications. CONCLUSIONS: Parental literacy level did not correlate with use of
preventive services or parental understanding of or ability to follow medical
instructions for their children.

PMID: 9685471 [PubMed - indexed for MEDLINE]


21. Spine (Phila Pa 1976). 1996 Oct 15;21(20):2352-5.

Prolapsed cervical intervertebral disc in male professional drivers in Denmark,
1981-1990. A longitudinal study of hospitalizations.

Jensen MV, Tüchsen F, Orhede E.

Department of Occupational Medicine, National Institute of Occupational Health,
Denmark, Copenhagen, Denmark.

STUDY DESIGN: This study of professional drivers is a part of a longitudinal
record linkage study of all economically active men in Denmark, identified on
January 1, 1981. Information about the main occupation was identified in 1980.
The cohort was followed for first hospitalization with prolapsed cervical
intervertebral disc until December 31, 1990. OBJECTIVES: To examine the risk of
prolapsed cervical intervertebral disc in all Danish professional drivers, and to
analyze exposures of the male drivers in a sample of all Danish male drivers.
SUMMARY OF BACKGROUND DATA: Only a few studies on occupation and prolapsed
cervical intervertebral disc have been published. These studies suggest that
professional driving may be a risk factor for development of prolapsed cervical
intervertebral disc. Drivers are exposed to whole-body vibrations, heavy lifting,
and a sedentary position. Other potential exposures are accelerations and
decelerations and whiplash accidents. Such exposure may be involved in the
causation of prolapsed cervical intervertebral disc. METHODS: A standardized
hospitalization ratio was calculated for each subgroup of drivers using all
economically active people as the standard. Additional exposure information was
extracted from a national survey on work environment. RESULTS: Almost all men in 
occupations involving professional driving had a statistically significant
elevated risk of being hospitalized with prolapsed cervical intervertebral disc. 
CONCLUSIONS: Professional driving is a risk factor for prolapsed cervical
intervertebral disc.

PMID: 8915070 [PubMed - indexed for MEDLINE]


22. Am J Ind Med. 1996 Oct;30(4):407-14.

Occupation and ischemic heart disease in the European Community: a comparative
study of occupations at potential high risk.

Tüchsen F, Andersen O, Costa G, Filakti H, Marmot MG.

National Institute of Occupational Health, Denmark, Copenhagen.

Four longitudinal studies of mortality and morbidity by occupation based on
individual record linkage of information and two cross-sectional studies of
mortality were compared in order to identify occupations at high risk of ischemic
heart disease. In more than one country an increased risk of ischemic heart
disease was found in drivers of buses, taxies, and lorries, in bakers, in naval
officers and fishermen, in hotel and restaurant workers, in senior police,
customs, and other uniformed men, in barbers and hairdressers, in warehouse and
wholesale staff, as well as in laboratory assistants and in radio and telegraph
operators. Occupations found at high risk in Denmark were also found at high risk
in Great Britain and Italy. These occupations may be at genuine high risk. None
of these groups work day-work only and several of the groups have psychologically
demanding work but unsatisfactory decision authority. Identification of
occupations at high risk may help to develop focused preventive strategies.

PMID: 8892545 [PubMed - indexed for MEDLINE]


23. Bull N Y Acad Med. 1996 Winter;73(2):370-97.

Occupations, cigarette smoking, and lung cancer in the epidemiological follow-up 
to the NHANES I and the California Occupational Mortality Study.

Leigh JP.

Department of Economics, San Jose State University, CA 95192-0114, USA.

What jobs are associated with the highest and lowest levels of cigarette use and 
of lung cancer? Are there gender differences in these jobs? Two data sets-the
Epidemiological Follow-up to the National Health and Nutrition Examination Survey
(NHEFS) and the California Occupational Mortality Study (COMS) were analyzed to
answer these questions. For females, the broad occupations ranking from highest
to lowest cigarette use in the NHEFS was: transportation operators, managers,
craft workers, service workers, operatives, laborers, technicians, administrative
workers, farm owners and workers, sales workers, no occupation, and
professionals. The corresponding ranking for males was: transportation operators,
no occupation, laborers, craft workers, service workers, technicians, and
professionals. The highest-ranking jobs in the COMS were waitresses, telephone
operators, and cosmetologists for women, and water-transportation workers,
roofers, foresters and loggers for men. Teachers were especially low on all four 
lists. This study could not determine whether employment within any occupation
encouraged smoking or if smokers selected certain occupations.

PMCID: PMC2359318
PMID: 8982527 [PubMed - indexed for MEDLINE]


24. J Occup Environ Med. 1995 Oct;37(10):1199-203.

Occupational injury and stress.

Johnston JJ.

National Institute for Occupational Safety and Health, Morgantown, West Virginia 
26505-2888, USA.

A literature search was conducted to identify studies that measured the
relationship between stress and occupational injury. Studies that provided a
quantitative measure of stress and occupational injury and a quantitative
assessment of the relationship between these two factors were selected for this
review. Twenty studies were identified, and all had P values of less than .05 or 
odds ratios ranging from .3 to 4.6. Twelve of 17 measures had odds ratios greater
than 1.0. Several factors limit the generalizability of these results, however,
and these include methodological differences in the assessment of stress and
injury, study design, and limited representation of occupations.

PMID: 8542339 [PubMed - indexed for MEDLINE]


25. J Paediatr Child Health. 1995 Jun;31(3):200-6.

A profile of heart disease risk factors and their relation to parents' education,
fathers' occupation and family history of heart disease in 843 South Australian
families: the Adelaide Children's WHO Collaborative Study.

Boulton TJ, Cockington RA, Hamilton-Craig I, Magarey AM, Mazumdar J.

University of Newcastle, New South Wales, Australia.

OBJECTIVE: A study was conducted to determine whether the prevalence of risk
factors among pre-adolescent children is associated with their parents' risk
factor status and what influence family history of ischaemic heart disease (IHD) 
and socio-economic status (SES) had. METHODOLOGY: This was a cross-sectional
study of 856 children, mean age 8.6 years, and their parents who underwent the
World Health Organization and National Heart Foundation protocols for the study
of arteriosclerosis precursors. Historical, demographic, anthropometric, clinical
and biochemical outcome measures were used. RESULTS: There was the expected
burden of illness reported for the grandparents and parents, with the latter
conforming to their expected age group's heart disease risk factor status. The
mean serum total cholesterol (TC) level for boys was 4.43 (+/- 0.79) mmol/L and
girls 4.62 (+/- 0.84) mmol/L, with the 95th percentile for boys and girls
combined being 5.88 mmol/L. The level corresponding to two standard deviations
above the mean was 6.0 mmol/L. Childrens' IHD risk factor status reflected their 
parents' with TC, skin fold thickness and body mass index most closely
correlated, followed by blood pressure. The greatest correlation was between the 
childrens' TC and their mothers'. Socio-economic status as assessed by the
parents' education level and fathers' occupational status produced differences in
their childrens' risk factors, with mother's level of education having the major 
influence. There was no impact of family history of IHD. CONCLUSIONS: From these 
results it would appear that screening of the pre-adolescent may be appropriate
but longitudinal study will be important to establish this by documenting
persistence of risk factor status. Also, it would appear that a child's future
risk from IHD morbidity may be due to environmental influences mediated through
differences in SES. As the level of IHD risk factors is reduced within the
community, the extent of parent-child transmission of measurable IHD risk factors
in families of high IHD risk may be reduced.

PMID: 7669380 [PubMed - indexed for MEDLINE]


26. Am J Ind Med. 1995 Jun;27(6):793-805.

A detailed analysis of work-related injury among youth treated in emergency
departments.

Knight EB, Castillo DN, Layne LA.

Division of Safety Research, National Institute for Occupational Safety and
Health, Morgantown, West Virginia 26505, USA.

Telephone interviews were conducted with 146 14- to 16-year-olds who incurred an 
occupational injury treated in an emergency department during the period July
through September 1992. Thirty-two percent of the injuries occurred as the result
of using equipment. Over half the workers reported not having received prior
training on how to avoid injury. The injury limited normal activities for at
least 1 day for 68% of the youth and for more than a week for 25%, corresponding 
to an estimated 6,208 (95% CI: 4,277, 8,139) and 2,639 (95% CI: 1,580, 3,699)
youths nationwide, respectively. Employment in retail trades, equipment use, lack
of training, and burn injuries were associated with increased limitation of
normal activities. Nineteen percent of the youths appear to have been injured in 
jobs declared to be hazardous, or typically prohibited for their age (14- and
15-year-olds) under federal child labor laws. The prohibited job directly
contributed to the injury in 64% of these cases.

PMID: 7645574 [PubMed - indexed for MEDLINE]


27. Prev Med. 1994 Mar;23(2):235-41.

Cigarette smoking among former military service personnel: a neglected social
issue.

Feigelman W.

Department of Sociology, Nassau Community College, Garden City, New York 11530.

BACKGROUND. This article investigates cigarettes smoking among active military
personnel, veterans, and comparable civilian populations. METHODS. It is based on
secondary analysis of archival data from the General Social Surveys and the
National Longitudinal Surveys of Youth. RESULTS. Findings were consistent with
past research, indicating higher smoking rates for current active military
personnel than for civilians. Among men and women who were in their thirties
during the early 1980s, findings suggest that military personnel and civilians
alike exhibited the same tendency toward cigarette use and initiated smoking at
approximately the same ages. General Social Surveys and National Longitudinal
Surveys of Youth data suggest that military smoking did not appear to be a
situational behavior which occurred only during a recruit's tour of duty; results
also suggest that previous military experience was associated with higher
lifelong patterns of cigarette consumption, compared to those who had never been 
in the armed services. CONCLUSIONS. This evidence suggests that the military--as 
the nation's largest employer, with an immense influence upon civilian
relations--exerts a force of considerable magnitude thwarting national goals to
achieve reduced cigarette consumption.

PMID: 8047531 [PubMed - indexed for MEDLINE]


28. Scand J Prim Health Care. 1993 Dec;11(4):234-40.

A clinical follow up of unemployed. II: Sociomedical evaluations as predictors of
re-employment.

Claussen B.

National Institute of Public Health, Unit for Health Services Research, Oslo,
Norway.

OBJECTIVE--To frame and study sociomedical evaluations in clinical work with
unemployed people. DESIGN--In a two-year follow up of routine health
examinations, three sociomedical evaluations were set up. The first was the
direct conclusion of the check-up, based on sickness and possibilities of
treatment. The second dealt with work identity, and the last was a diagnostic set
of main unemployment problem. SETTING--The four municipalities of Grenland,
Norway. PARTICIPANTS--A representative sample aged 16 to 63 who had been
registered with the labour market authorities for more than 12 weeks.
RESULTS--21% of the unemployed needed further treatment. 7% were classified as
"discouraged", being on their way out of the labour market, while the majority of
the study group was healthy job seekers. Work identity seemed to be wage earning 
for 83%, homemaking for 9%, cultural work for 3%, and being a pensioner for 5%.
The main unemployment problem was lack of work for 46% of the examined. Other
problems were poor health, being less attractive workers, or having little
courage for job search. The evaluations predicted re-employment after two years. 
They divided the unemployed in groups with from five to seven times difference in
re-employment rate. CONCLUSION--These standardized sociomedical evaluations seen 
to be useful in clinical work with unemployed people.

PMID: 8146506 [PubMed - indexed for MEDLINE]


29. East Afr Med J. 1992 Feb;69(2):55-7.

Unusual form of motor neuron disease in Kenya.

Adam AM.

Department of Medicine, College of Health Sciences, University of Nairobi, Kenya.

Comment in:
    East Afr Med J. 1992 Feb;69(2):53-4.

Over the period November 1978 to October 1988, 46 cases of motor neuron disease
were seen at Kenyatta National Hospital, Nairobi. One case was seen in private
practice. A bimodal age distribution of the disease was identified with a peak in
the fourth decade of life and another peak in the sixth decade of life. The
disease seen in the fourth decade of life was different as seen in other parts of
the world in that the majority of patients tended to present with very rapidly
progressive disease despite the primary presentation with limb symptoms and
signs. Serum cholinesterase activity in five of these patients and five of the
classical motor neuron disease revealed no abnormalities. This unusually rapidly 
progressive disease in young adults has not been described anywhere. The disease 
seen in older age groups and especially in patients over fifty years of age was
not different from the one seen in other parts of the world.

PMID: 1505388 [PubMed - indexed for MEDLINE]


30. Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1450-6.

The effect of physical activity during pregnancy on preterm delivery and birth
weight.

Klebanoff MA, Shiono PH, Carey JC.

Division of Prevention Research, National Institute of Child Health and Human
Development, National Institutes of Health, Bethesda, MD 20892.

The relationship between physical activity during pregnancy, preterm birth, and
gestational age-adjusted birth weight was investigated prospectively in a cohort 
of 7101 women. This study is one of few to evaluate both employment- and
non-employment-related physical activity. Prolonged periods of standing were
associated with a modestly increased risk of preterm delivery (adjusted odds
ratio for greater than or equal to 8 hours/day of standing = 1.31). Heavy work or
exercise was not associated with preterm delivery (adjusted odds ratio for
greater than or equal to 4 hours per day of heavy work = 1.04). The proportion of
infants born preterm did not differ among women working in predominantly
standing, active, and sedentary occupations. Physical activity was not associated
with gestational age-adjusted birth weight after controlling for confounding
variables. These data suggest that unmeasured socioeconomic differences among
women reporting different levels of activity may account for previously described
associations between physical activity and pregnancy outcome. Most pregnant women
who report increased levels of physical activity are not at increased risk of
preterm delivery or reduced intrauterine growth. However, these data do not
address the role of activity restriction in the management of selected women at
high risk for adverse pregnancy outcome.

PMID: 2240086 [PubMed - indexed for MEDLINE]


31. Am J Epidemiol. 1990 Aug;132(2):293-303.

Incidence of leukemia in occupations with potential electromagnetic field
exposure in United States Navy personnel.

Garland FC, Shaw E, Gorham ED, Garland CF, White MR, Sinsheimer PJ.

Naval Health Research Center, San Diego, CA 92186-5122.

Leukemia is the fourth most commonly occurring cancer in the United States
population between the ages of 17 and 34 years, an age group heavily represented 
in the US Navy. Historical computerized military career records maintained at the
Naval Health Research Center, San Diego, California, were used to determine
person-years at risk (total, 4,072,502 person-years) by demographic
characteristics and occupation for active-duty naval personnel during 1974-1984. 
Computerized inpatient medical records were searched for first hospitalizations
for leukemia. Cases of leukemia (n = 102) were verified by using pathology
reports or Navy Medical Board or Physical Evaluation Board findings. For
comparisons, age-adjusted incidence rates and standardized incidence ratios were 
calculated by using rates for the US population provided by the Surveillance,
Epidemiology, and End Results program of the National Cancer Institute. The
overall age-adjusted incidence rate of leukemia in active-duty naval personnel
was found to be very close to that of the Surveillance, Epidemiology, and End
Results program population (6.0 vs. 6.5 per 100,000 person-years). Only one
occupation, electrician's mate, emerged with a borderline statistically
significant excess risk of leukemia (standardized incidence ratio compared with
the Surveillance, Epidemiology, and End Results program population = 2.4, 95%
confidence interval 1.0-5.0). This finding is intriguing in the light of several 
studies showing an excess risk of leukemia associated with exposure to
electromagnetic fields.

PMID: 2372008 [PubMed - indexed for MEDLINE]


32. Int J Gynaecol Obstet. 1989 Dec;30(4):305-11.

Pregnancy outcome in unmarried teenage nulligravidae in Singapore.

Kurup A, Viegas O, Singh K, Ratnam SS.

Department of Obstetrics and Gynaecology, National University of Singapore,
National University Hospital.

Singapore, like other newly industralized countries, has seen a dramatic
transformation in the social standards of its population in a particularly short 
space of time. Unfortunately, this period of development has been accompanied by 
an escalation in the number of pregnancies to unmarried teenage girls. This paper
examines the obstetric and social implications of 150 such pregnancies in younger
and older teenagers. Poor intrauterine growth in the younger teenager appears to 
be the most important adverse obstetric outcome in that mean birthweight was
significantly reduced (2738 g compared to 3054 g; P less than 0.02). We believe
this to be an important explanation for the five-fold increase in perinatal
mortality seen in this group of mothers. Unlike some other reports, we found no
significant increase in the incidence of cephalopelvic disproportion, anemia or
pregnancy induced hypertension in these mothers. The social implications of
teenage pregnancy in Singapore are also examined and recommendations made for
methods to curb the problem.

PIP: Singapore, like other newly industrialized countries, has seen a dramatic
transformation in the social standards of its population in a particularly short 
space of time. Unfortunately, this period of development has been accompanied by 
an escalation in the number of pregnancies to unmarried teenage girls. This paper
examines the obstetric and social implications of 150 such pregnancies in younger
and older teenagers. Poor intrauterine growth in the younger teenager appears to 
be the most important adverse obstetric outcome in that mean birthweight was
significantly reduced (2738 g compared to 3054 g; p 0.02). We believe this to be 
an important explanation for the 5-fold increase in perinatal mortality seen in
this group of mothers. Unlike some other reports, we found no significant
increase in the incidence of cephalopelvic disproportion, anemia, or pregnancy
induced hypertension in these mothers. When adolescents become mothers, they tend
to follow a social path of failure: they do not remain in school, they do not
limit family size, establish a stable family, establish a vocation, have healthy 
infants, or have children who fulfill their potential. Education of the teenagers
in Singapore is recommended to reduce the teenage pregnancy problem. author's
modified

PMID: 2576537 [PubMed - indexed for MEDLINE]


33. Sex Roles. 1981 Jan;7(1):35-47.

Family timing in late adolescence and early adulthood: the case of southern
males.

Marshall KP, Zito GV, Cosby AG.

PIP: A model of processes underlying marriage and family timing were applied to
longitudinal data on 288 young adult males from the Southern Youth Study. The
purpose was to assess the implications which adolescent status and familial
orientations may hold for patterns of family formation and expansion. The
subjects were selected from nonmetropolitan high schools in Alabama, Georgia,
Texas, and South Carolina. Initial contact was made in the sophomore year
(1966-1967) when family background and significant other encouragement data were 
requested through questionnaires administered in the classroom. Recontacted as
seniors in 1968, respondents were questioned concerning status and family
aspirations. In 1972 the respondents were contacted for a 3rd time and data
regarding marriage timing and procreation were obtained. 45% of the 288 males had
married within 4 years of high school, but 81% reported no children. 16% reported
1 child and only 3% reported 2 or more children. On the average, as high school
seniors, these males expressed desires for slightly later marriage than did males
in the Project Talent national study of high school seniors. The expected
negative relationships of early fertility with significant other occupational
encouragement and with educational aspirations indicated high aspirations to be
associated with lower young adult procreation. The strongest correlation
reflected the importance of marital timing. Premarital factors failed to directly
influence procreation independently of marital duration and only adolescent
educational and marital desires directly influenced the timing of marriage.

PMID: 12310209 [PubMed - indexed for MEDLINE]