Social differences in health in an affluent Danish county

Searching for one word to describe the state of mind of the physician in the United States today, we might choose beleaguered. Threats appear from all sides--from payers, would-be managers of care, the growth of technology, and even patients. The rhetoric is one of siege and battle, and the dynamic seems to be a clash of values from which only one winner can emerge. But scientific and health services research suggest otherwise. Science suggests that health care could, indeed, perform a great deal better than it does today and that a shared aim of improving health outcomes for patients at a cost that society can afford is sensible and within reach. However, achievement of these improvements will require of physicians not handwringing and resistance to change but concerted, positive, capable leadership. The goal of this series in Annals is to describe a new knowledge base that will help physicians participate effectively in the redesign of the health care system. The series is intended to raise the curiosity of physicians about the skills they will need to become more active and influential citizens of the health care community in accomplishing improvements. These skills will help physicians better deploy their clinical expertise and professional purpose in a debate that has heretofore been informed primarily by economics.     

A population study of low-rate smokers: Quitting history and instability over time.

This study used 1 longitudinal and 2 cross-sectional population surveys to compare stability of low-rate daily smokers (less than 5 cigarettes per day) with other daily smokers and occasional smokers. Few low-rate smokers maintained consumption level; 36% retained smoking status after 20 months, compared with 82% and 44% for regular daily and occasional smokers, respectively. In a dynamic process, established smokers quit smoking and/or modified (decreased or increased) consumption. Low-rate and occasional smokers quit at higher rates than regular daily smokers (odds ratios 3:1) but were replenished by new members, many converted from regular daily smokers. The overall trend is an increasing proportion of low-consumption smokers while smoking prevalence declines. The dynamic process has implications for tobacco control efforts and for addiction theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nutritional iodine supply in Germany. Results of preventive measures

Germany is an iodine deficiency area with endemic goitre. The prophylactic procedures which have been initiated gradually since 1983, were different between the eastern and western part of Germany. In East Germany iodine supply could be improved by "mandatory prophylaxis" until 1989. However, after the reunification of Germany and the adaption of the "voluntary principle", the iodine intake decreased again. In December 1993, new regulations concerning iodized salt became effective (so called "2nd decree") combined with a relaxation of the declaration of duty. This relaxation considerably contributed to the significant increase in iodized salt utilisation in food production. The rise of iodine content of food and breast milk, the higher iodine intake with food, the decrease of fetal thyroid volume and the increase in renal iodine excretion are clear indicators of a better iodine supply. However, the desired target figures have not been obtained yet.     

Modeling homophily over time with an actor-partner interdependence model.

Selection and socialization have been implicated in friendship homophily, but the relative contributions of each are difficult to measure simultaneously because of the nonindependent nature of the data. To address this problem, the authors applied a multiple-groups longitudinal actor-partner interdependence model (D. A. Kashy & D. A. Kenny, 2000) for distinguishable dyads to 3 consecutive years of intoxication frequency data from a large community-based sample of Swedish youth. Participants, ranging from 12 to 18 years old (M = 14.35, SD = 1.56) at the start of the study, included 902 adolescents (426 girls and 476 boys) with at least one reciprocated friend during at least one time point and 212 adolescents (84 girls and 128 boys) without reciprocated friends at any time. Similarity estimates indicated strong effects for selection and socialization in friends' intoxication frequency. Over time, younger members of these dyads had less stable patterns of intoxication than older members, largely because younger partners changed their drinking behavior to resemble that of older partners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The composition of dietary lipids and the blood coagulation time in the rat

The study of the coagulation in rats fed with a balanced diet, including 12% of different animal or vegetable fats, during 6 months, shows that the time of coagulation in rats receiving one of the following oils: palm, sunflower, Canbra, is significantly higher than the ones fed with butter. On the other hand, the coagulation time observed in the groups is correlated with the oleic acid level in the corresponding diet. The results obtained here may lead to important practical applications.     

The prevalence of rheumatoid arthritis in affluent and poor urban communities of Pakistan

Using previously applied methods a survey of joint symptoms was undertaken among 4232 adults, evenly distributed between affluent and poor areas of Karachi, Pakistan. Only six cases of definite rheumatoid arthritis (RA) (1958 ARA criteria) were identified in the 245 persons who complained of joint problems of at least 4 weeks duration. The prevalence was 0.9 [confidence interval (CI) 0.21-3.61] and 1.98 (CI 0.55-5.1) per thousand in the poor and affluent districts, respectively. These were substantially less than prevalence rates reported in the West but were similar to figures derived from other developing countries. There was no obvious impact of current living standards on the findings. The relative paucity of older female subjects in both the affluent and poor communities may account at least in part for the low rates observed. The infrequency of rheumatoid nodules in Southern Asians with RA illustrates the difficulty of applying existing diagnostic criteria to this community.     

Law enforcement in an urban society.

Discusses 4 conditions which affect the capability of the judicial and law enforcement systems to cope with crime and presents several recommendations that may ease the workload and mitigate the potential ineffectiveness of the legal establishment. The law explosion (i.e., the quantitative and qualitative problems associated with social conflicts that are settled by law); the malaise in criminal law (e.g., incomplete and misunderstood crime statistics and reports and the uneven distribution of resources in the legal system); organizational fragmentation within the judicial, police, and law networks; and the overload of the courts are considered to be the major problems which face legal authorities concerned with the reduction in crime. Attention is focused on the discrepancies in role expectations of the police and the various systems of control which affect police behavior. Suggested remedies include additional resources, a redistribution and reorganization of present resources, and new means of judging social crimes, possibly decriminalization. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

生物柴油喷射火焰燃烧不稳定性特征的非线性研究

引入一种图像处理技术和非线性时间序列分析方法对生物柴油喷射火焰的燃烧不稳定性进行了分析.燃烧室内火焰二维图像的灰度值分布一定程度上反映了燃烧温度的分布状态,通过经典的关联维数方法和最大李雅普诺夫指数方法对这种灰度值时间序列进行分析比较,结果发现火焰混沌显然存在于燃烧不稳定过程之中.     

The child in our society

Peter Berger once said that children are our "hostages to history", we expect them to ensure continuity. At the same time we project our wishes on them, they are our vectors of the future. Public discourse on children in modern society--charged with historical traditions and diverse expectations--provides a seismographic reading of our hopes and fears as the 20th century draws to a close. Pessimistic attitudes, the sense of looming dangers, appear to be ever more widespread, the discourse about modern childhood takes on an apocalyptic tone, children are seen increasingly as victims or dangerous delinquents. There are complaints that childhood disappeared or would be extended more and more. The paper provides a critical review of present day attitudes to children, investigates the current situation, and discusses the dilemmas that have arisen in the conditions of life and relations between the generations in modern civilization. But a question is also asked: How can we create the conditions that will do children and adults good? Last but not least, what can the health and social services contribute to making childhood worth living?     

On changes in psychiatric diagnosis over time.

Examined the factors determining diagnoses of types of mental illness. A survey of the age and diagnosis of 2,134 male psychiatric inpatients discharged from a single treatment facility in 1954, 1964, and 1974 revealed 3 major diagnostic trends: (a) the proportion of patients with affective disorders increased threefold, (b) patients with neuroses went from being the largest group to one of the smallest, and (c) schizophrenia increased significantly. In-depth examination of changes in the psychiatric process revealed that shifts in the patient population and symptomatology could not fully explain these trends. The relative importance of similar symptoms appeared to be interpreted differently at various historical times; diagnosis itself seemed to be relative to historical period. Possible causes include shifts in the patient population, increased treatment of neurotic patients on an outpatient basis, and changes in diagnostic categories due to increased clinical knowledge. It is suggested that the change in treatment emphasis from a psychological/psychoanalytic perspective to a psychopharmacological/medical one may be correlated with an increase in diagnoses more consistent with biological treatment (e.g., affective disorders and schizophrenia) and a decrease in categories less appropriate for this model (e.g., neurosis). (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in pediatric ICU mortality risk over time

OBJECTIVES: To compare pediatric intensive care unit (ICU) mortality risk using models from two distinct time periods; and to discuss the implications of changing mortality risk for severity systems and quality-of-care assessment. DATA SOURCES AND SETTING: Consecutive admissions (n = 10,833) from 16 pediatric ICUs across the United States that participate in the Pediatric Critical Care Study Group were recorded prospectively. Data collection occurred during a 12-mo period beginning in January 1993. METHODS: Data collection for the development and validation of the original Pediatric Risk of Mortality (PRISM) score occurred from 1980 to 1985. The original PRISM coefficients were used to calculate mortality probabilities in the current data set. Updated estimates of mortality probabilities were calculated, using coefficients from a logistic regression analysis using the original PRISM variable set. Quality-of-care tests were performed using standardized mortality ratios. RESULTS: Risk of mortality from pediatric ICU admission improved considerably between the two periods. Overall, the reduction in mortality risk averaged 15% (p < .001). Analysis of mortality risk by age indicated a large improvement for younger infants. The mortality risk for infants <1 mo improved by 39% (p < .001). Mortality risk improved by 28% (p < .001) for infants between 1 and 12 mos. Analysis of mortality risk by principal diagnosis indicated substantial improvement in respiratory diseases, including respiratory diseases developing in the perinatal period. The mortality risk for respiratory diseases improved by 45% (p < .001). The improvement in mortality risk substantially deteriorated the calibration of the original PRISM severity system (p < .001). As a result of changing mortality risk, the standardized mortality ratios across the 16 pediatric ICUs demonstrated substantial disparities, depending on the choice of models. CONCLUSIONS: This study documents differences in pediatric ICU risk of mortality over time that are consistent with a general improvement in the quality of pediatric intensive care. Despite continued widespread use of the original PRISM, recent improvements in pediatric ICU quality of care have negated its usefulness for many intended applications, including quality-of-care assessment.     

Children's and adults' long-term memory for spatial locations over an extended time period.

Eight-, 11-, and 19-year-olds' memory for spatial locations over an extended time period was assessed. Subjects participated in two experimental sessions that were separated by an average of 5 months. All subjects walked through the environment during the fall session, but only half of the subjects at each age level made bearing and distance estimates to target locations. During the subsequent spring session, all subjects made bearing and distance estimates to the same targets. Accuracy at all age levels in the spring was unaffected by (a) the opportunity to recall locations in the fall and (b) the number of walks through the environment in the fall. However, the bearing accuracy of 8- and 11-year-olds declined significantly from fall to spring, whereas the accuracy of 19-year-olds remained stable. It was suggested that adults remember spatial location information better than children over an extended time period because they code location information in more organized representations and/or more effectively use environmental stimuli as retrieval cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Searching for justice: The discovery of IQ gains over time.

Humane-egalitarian ideals, whose aims are group justice and reducing environmental inequality and privilege, must be tested against reality, as revealed by psychology and other social sciences. Four issues are addressed: the equation between IQ and intelligence, whether group potential is determined by a group's mean IQ, whether the Black–White IQ gap is genetic, and the meritocratic thesis that genes for IQ will become highly correlated with class. Massive IQ gains over time test the IQ–intelligence equation, reveal groups who achieve far beyond their mean IQs, and falsify prominent arguments for a genetic racial IQ gap. Class IQ trends suggest America is not evolving toward a meritocracy, but a core refutation of that thesis is needed and supplied. Finally, the viability of humane ideals is assessed against a worst-case scenario. (PsycINFO Database Record (c) 2010 APA, all rights reserved)