Improved body distribution of 14C-labelled AZT bound to nanoparticles in rats determined by radioluminography

This article describes socioeconomic differences in the time course of several health indicators, encompassing perceived health and disabilities, among a population sample of persons reporting one or more chronic conditions. Data covering the period 1991-1993, were obtained from a Dutch follow-up study. Educational differences in the course of health status were estimated by ordinary least squares regression. The course of almost all health status measures was statistically significantly less favorable (p<0.05) for those with a low educational level compared to those with higher vocational training or a university degree, adjusting for age, sex, and marital status. After additional adjustment for health status in 1991, significant differences remained for perceived general health, long-term disabilities, and two subscales of the Nottingham Health Profile. These findings imply that socioeconomic differences in prevalence of health problems are not only attributable to differences in incidence of diseases by socioeconomic status, but also to a differential course of existing health problems. Implications for health care delivery are discussed.     

Alternate models of sibling status effects on health in later life.

Although siblings are thought to be influential in child development, little is known about the influence of sibling status on the health of older adults. Using structural equation modeling, the authors created and tested a series of models with data from a sample (N = 3,968) of 1957 high school graduates from the Wisconsin Longitudinal Study. The results indicated that socioeconomic status of origin, adolescent aptitude, and educational attainment did have significant total effects on health in later life, but sibling status did not. Adults who grew up in families of higher socioeconomic status and who had greater aptitude in high school attained more education, and this advantage, in turn, led to better health in later life. Although the final model was cross-validated, it was not equally plausible for men and women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A reappraisal of mouth-to-mouth ventilation during bystander-initiated cardiopulmonary resuscitation: a statement for Healthcare Professionals from the Ventilation Working Group of the Basic Life Support and Pediatric Life Support Subcommittees, American Heart Association

There is growing recognition that race and socioeconomic variables in health research demand greater attention. The investigators compared racial differences in health definition, health value, and health-promoting behavior of 62 pairs (N = 124) of Black and White college women matched on age, body mass index, and socioeconomic status. Both groups of women had similar definitions of health, valued health to the same extent, and reported similar levels of self-actualization, health responsibility, exercise, and stress management. Black women, relative to White women, practiced fewer nutrition behaviors and had less interpersonal support. Interventions to reduce health risk associated with nutrition practices of Black women are warranted and further research is needed to explore the influence of the social structure of educational institutions on interpersonal relationships and other health behaviors. When socioeconomic status is taken into consideration, Black and White college women demonstrated more commonalities in health behavior than differences.     

Four ways to teach PHC in a changing world

Nurse educators are challenged to revise teaching/learning methods to support community-based primary health care (PHC) systems. The key elements are: integrating education with the realities of practice and people's needs; moving communities to strive towards solving their own health problems; and recognizing the socioeconomic health determinants. Described below are four educational methods based on PHC: inquiry-based learning, IMPACTS (a game to encourage multisectoral collaboration), distance education and community-based education.     

Activities and well-being in older age: Effects of self-concept and educational attainment.

The positive effect of activities on well-being is proposed to be mediated by self-conceptualizations and facilitated by socioeconomic status. The hypothesized processes were estimated with LISREL VIII using data from a large cross-sectional survey with a sample of 679 adults aged 65 and older who were representative of older adults living in the Detroit area. Findings indicate that the frequency of performing both leisure and productive activities yields an effect on physical health and depression and that these effects are mediated in part by a sense of self as agentic, but less clearly by a sense of self as social. Furthermore, socioeconomic status, operationalized as formal educational attainment, facilitates the effect of leisure to a greater extent than that of productive activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health status, somatization, and severity of posttraumatic stress disorder in Vietnam combat veterans with posttraumatic stress disorder

OBJECTIVE: A two-part study was conducted to examine the health status of Vietnam veterans with posttraumatic stress disorder (PTSD). In part 1, veterans with and without PTSD were compared on health behaviors and on self-reported and physician-rated health problems. Consistency of self-report with physician rating for health problems across the two groups was compared. In part 2, the association between health status and PTSD symptom severity, depression, somatization, and health behaviors in PTSD patients was evaluated. METHOD: In part 1, 276 combat veterans (225 with PTSD and 51 without PTSD) provided health status information, and medical records were reviewed. In part 2, 225 PTSD patients completed standardized PTSD severity, somatization, and depression measures. RESULTS: When analyses controlled for age, socioeconomic status, minority status, combat exposure, alcohol use, and pack-year history, veterans with PTSD reported and were rated as having a greater number of health problems than veterans without PTSD. Agreement between self-report and physician ratings for both groups ranged from low to moderate. Level of agreement between patient and physician was similar across groups. In the analysis of veterans with PTSD, somatization and PTSD symptom severity were significantly related to self-report of health problems, whereas only PTSD symptom severity was related to physician-rated health. Pack-year history was significantly related to self-reported health status in both groups. CONCLUSIONS: The presence and severity of PTSD in veterans were associated with greater physical health problems and conditions. Psychological variables (e.g., PTSD status, PTSD severity, somatization) and a behavioral variable (pack-year history) were related to health status.     

Contribution of psychosocial factors to socioeconomic differences in health

The National Survey of Mid-life Developments in the United States (MIDUS) is one of several studies that demonstrate socioeconomic gradients in mortality during midlife. When MIDUS findings on self-reported health, waist to hip ratio, and psychological well-being were analyzed for their possible roles in generating socioeconomic differences in health, they revealed clear educational gradients for women and men (i.e., higher education predicted better health). Certain potential mediating variables, like household income, parents' education, smoking behavior, and social relations contributed to an explanation of the socioeconomic gradient. In addition, two census-based measures, combined into an area poverty index, independently predicted ill health. The results suggest that a set of both early and current life circumstances cumulatively contribute toward explaining why people of lower socioeconomic status have worse health and lower psychological well-being.     

What if socioeconomics made no difference?: access to a cadaver kidney transplant as an example

OBJECTIVES: Several studies have noted the impact of socioeconomic factors on access to expensive medical care, but none of those studies controlled for self-reported health and functional status or attitudes about treatment alternatives when analyses were completed. Because these factors may be correlated with socioeconomic status, the failure to control for them may have led to bias in other studies. The authors merged data from secondary sources with telephone survey data from a national sample of 456 end-stage renal disease patients to show how estimates of the effects of socioeconomic factors change when self-reported health and functional status and attitudes about treatment are incorporated into statistical models. The authors also showed how kidney transplant rates would change if socioeconomic factors no longer influences organ allocation decisions. METHODS: Weibull proportional hazard analyses were used to show relationships between socioeconomic measures and waiting list entry and kidney transplant rates, before versus after accounting for self-reported health and functional status, attitudes about treatment, and other variables. Simulation analyses were used to estimate the number of waiting list spots and transplant operations that would move from economically advantaged to disadvantaged persons if socioeconomics no longer influenced organ allocation decisions. RESULTS: Incorporating information about health and functional status, attitudes about treatment, and other factors into the hazard models often reduced the estimated impact of socioeconomic measures on the odds of (1) being on a waiting list for a cadaver kidney transplant and (2) receiving a transplant. Simulations showed that 30 to 65 waiting list spots or transplant operations per 1,000 patients would shift from economically advantaged to disadvantaged persons if socioeconomics no longer influenced organ allocation decisions. CONCLUSIONS: Successful efforts to level the playing field would result in substantial redistributions of kidney transplants from economically advantaged to disadvantaged persons.     

Poverty and women's mental health.

The positive association between poverty and mental health problems is one of the most well established in all of psychiatric epidemiology. Research has documented consistently that low income and low socioeconomic status are associated with high rates of mental disorder. With the prevalence of poverty itself now on the rise in our country, particularly among women, children and those from minority groups, increased attention must be paid to the mental health risks that accompany poverty. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

S-100 protein-positive dendritic cells in follicular lesions of the thyroid

To assess recall of childhood socioeconomic position for public health research, the authors conducted a cross-sectional study of 352 adult women twin pairs enrolled in Examination II of the Kaiser Permanente Women Twins Study carried out in 1989-1990 in Oakland, California. Among twin pairs, 91% (95% confidence interval (CI) 89-94%) agreed on their father's educational level and 81% (95% CI 77-85%) on their childhood social class. Recall did not differ by adult socioeconomic position, zygosity, race/ethnicity, or age. Thus, epidemiologic studies can validly use retrospective data on childhood socioeconomic position to study its relation to adult health status.     

Health practices and indices of a poor urban population in Indonesia. Part I: Patterns of health service utilization

This first section in a two-part study of health indices and practices among residents living in a Jakarta slum describes the use of public and private primary health care services in relation to socioeconomic and health status. As problems associated with urban poverty rapidly increase in developing countries, it is important to study the ethnic and economic diversity which exists in slums and shanty towns: results of such studies should inform the development of effective strategies for outreach and service delivery. Through a survey of 690 mothers and 593 children, we found that 1) poorer residents were more likely than relatively affluent ones to rely on local government clinics (posyandus) for primary health care; 2) regular posyandu users were more likely than non-users to be fully immunized and to use ORT correctly; 3) delivery in hospital was common among all residents, but especially among the more affluent; and 4) prevalence of contraception was high and not associated with socioeconomic status or type of primary health care service used. Strengthening primary health care services at the government's local health posts could benefit all groups in the community if wealthier residents participated more in the posyandus. Standards of care in the private sector should also be improved.     

Military rank as a measure of socioeconomic status and survival from prostate cancer

Previous studies have shown an association between cancer survival and socioeconomic status. In the United States Armed Forces, military rank is a measure of socioeconomic status. To determine whether an association exists between socioeconomic status (as measured by military rank) and prostate cancer, we carried out a retrospective review of the clinical data from 237 patients entered into the Tumor Registry. There was no statistically significant association between rank and the stage of disease at diagnosis or actual 5-year survival. In the military, health care is provided free of charge, independent of rank, and this study showed that when there is equal access to health care, socieconomic status does not correlate with prostate cancer outcome. Future studies comparing outcomes of prostate cancer should control for accessibility to health care.     

Socioeconomic status and health in blacks and whites: the problem of residual confounding and the resiliency of race

A large number of epidemiologic studies have focused on racial/ethnic differences, particularly between blacks and whites. Because health endpoints and racial categorizations are associated with socioeconomic status, investigators generally adjust for socioeconomic indicators. The intention is usually to control for confounding, thereby making groups comparable and excluding socioeconomic status as an alternative explanation to hypotheses of innate physiologic differences. A threat to the validity of these analyses is therefore the presence of residual confounding. We identify four potential sources of residual confounding in this analytical design: categorization of socioeconomic status variables, measurement error in socioeconomic indicators, use of aggregated socioeconomic status measures, and incommensurate socioeconomic indicators. Using simulations and examples from the literature, we demonstrate that the effect of residual confounding is to bias interpretation of data toward the conclusion of independent racial/ethnic group effects. Investigators often refer to possible "genetic" differences on the basis of models that control for socioeconomic status. We propose that such conclusions on the basis of this analytical strategy are generally unwarranted. Racial/ethnic differences in disease are a pressing public health concern, but the current approach does not often provide a basis for inference about putative biological factors in the etiology of this disparity.     

Synthesis and activity of partial retro-inverso analogs of the antimetastatic laminin-derived peptide, YIGSR-NH2

Very low birth weight (VLBW) children at school age show variability in their outcome, compared with normal birth weight children, although many early physical and health differences are equalized by middle childhood. Studies of nonhandicapped VLBW children have found a higher rate of school retention and school problems in this population. Differences in intelligence have been reported, although these are often confounded by socioeconomic factors such as educational level of the parent. Few studies today of children born in the late 1970s and early 1980s have related school age outcome to central nervous system (CNS) status, yet for learning disabilities or other neuropsychological deficits, this may be highly relevant. Better understanding of medical risk factors, however, will not affect the decisive influence of social factors on their expression in the school age child.     

Low education, high GP consultation rates: the effect of psychosocial factors

The purpose of this study was to estimate the contribution of psychosocial factors to the increased use of a general practitioner (GP) among those with a lower level of education. The use of GP services was elicited from survey data from 2867 respondents from the Dutch Longitudinal Study on Socio-Economic Differences in the Utilization of Health Services (LS-SEDUHS) using a simple "Yes/ No" format. Psychosocial variables included long-term stressful conditions, social support, external locus of control, coping styles, and tendency to consult (a measure of people's propensity to go to a doctor with health problems). People with primary education used the GP services more than people with higher vocational training or a university degree (OR 1.87, p<0.05), adjusted for health status and health insurance. Only tendency to consult partially explained this difference (OR: 1.74, p>0.05). Most psychosocial factors do not seem very important in explaining high GP utilization rates among those with a low socioeconomic status. Alternative explanations are discussed.     

Enantiomeric determination of amphetamine and methamphetamine in urine by precolumn derivatization with Marfey''s reagent and HPLC

In this report we (i) measure the strength of the association between paediatric trauma visit rates and regional socioeconomic and demographic variables, and (ii) quantify any selective impact of user charges on service demand in socioeconomically and demographically different areas. During the period 1989-94, a total of 30,362 home and leisure injury visits were made to the Aurora City Hospital. The visit rates are analysed using a random effects model. In addition, the areas are ranked into three groups in accordance with a socioeconomic index measure, and the annual visit rates of the three groups are calculated. We found fairly minor differences in children's visit rates between unequal socioeconomic areas, and it is apparent that socioeconomic status cannot explain the change in visit rates as a result of the introduction of user charges. We speculate that these changes in emergency visit rates will not lead to long-term health problems among any segment of the city population.     

The current problems in protecting the health of the population in the oil- and gas-producing regions of Tyumen Province

A socioeconomic and medicodemographic analysis of modern problems related to population health protection in the oil and gas extraction regions of Tyumen Province has been carried out under conditions of radical reconstruction of the national economy. Changes in the parameters of natural migration of the population for each year over a period of 1991 to 1995 are followed up, and specific features of the migration processes, effects of socioeconomic and medical factors on the health status of individual population groups, rates of increment in the number of disabled subjects, and population mortality from various causes analyzed. The authors discuss the status of public health services and offer measures for improving their efficacy in the above regions.     

Postsecondary education preparation of traditionally underrepresented college students: A social capital perspective.

The messages and support that students receive regarding college preparation often varies by students' race/ethnicity, socioeconomic background, and generational status (Adelman, 2006; Freeman, 1997; McDonough, 2004; Venezia & Kirst, 2005; Wimberly, 2002). This investigation sought to understand the manner by which a social capital framework could help explain how information about postsecondary educational transitions was communicated to, and interpreted by, college-bound students in one large urban school district. African American college students retrospectively considered the people, both in school and out, who provided them with college preparatory information, support, and/or guidance. Data revealed that although students received encouragement from their social networks, there was a shortage of individualized, concrete, and comprehensive college planning. Findings suggest that college planning and preparation for students from traditionally underrepresented college populations must be more cohesive and focused toward providing access to academic, financial, and social information that is instrumental in the students' transitions to college. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways to adversity in young adulthood among early childbearers.

Women who give birth as teens differ from those who delay childbearing before and after a birth. These preexisting differences may account for the adverse outcomes faced by early childbearers in young adulthood. This study tested whether a history of conduct disorder, low IQ and educational attainment, and low childhood socioeconomic status accounted for poor psychosocial adjustment at age 26 among early childbearers. Study members were 482 women in a birth cohort, 26% of whom had given birth by age 26 in 1999. Findings supported the hypothesis that individual and family background factors partially accounted for the adverse socioeconomic, mental health, and interpersonal outcomes faced by young mothers. However, early childbearing exacerbated the difficulties associated with these risk factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic status and traditional treatment approaches reconsidered.

Notes that while mental health services and research with traditional therapies are scarce, innovative treatment approaches are employed increasingly with low-income patients. It is suggested that pertinent data must be carefully considered lest the present trend produce separate and unequal services for various social groups. While socioeconomic status appears to be a significant correlate of acceptance for, and duration of, individual psychotherapy, it does not relate to treatment outcome. Clarification of this discrepancy requires a more precise identification of the social groups comprising the "lower-classes," a clearer understanding of the environmental demands faced by such patients, and an objective assessment of specific socioeconomic status factors that may exclude a given patient from a given treatment. It is concluded that resolution of such issues is necessary for a realistic allocation of available mental health services. (75 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)