Physical disability, physical attractiveness, and social outcomes in children's small groups.

Examined the sociometric status of children with obvious physical handicaps in an integrated (approximately 70% Black, 20% Puerto Rican, and 10% White) summer camp setting containing 61 girls (aged 7.5–14 yrs) and 60 boys (aged 7.75–14 yrs). 23% of Ss had obvious physical handicaps (e.g., spinal injuries, limb deformities), and 33% had some form of chronic illness or physical condition (e.g., sickle cell anemia, pulmonary insufficiency). Ss were interviewed during the 3rd wk of camp on questions concerning who they liked best in their groups and how they made friends. In addition, 12 male and 12 female children from neighboring camps were shown full-body photographs of all Ss and asked to rate them for attractiveness. Results indicate that handicapped Ss were less preferred as friends than their able-bodied peers. Physical attractiveness was also related to sociometric standing, as well as to the presence or absence of a physical handicap. An analysis of the relationship between physical attractiveness and social status for Ss alone indicated that these variables were significantly related for this group. Significant differences were found between obviously handicapped and able-bodied Ss on a knowledge-of-friend-making task; but among the latter group, role-play scores did not differentiate high- from low-status Ss. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental disorders in elderly suicide

The purpose of this study was to investigate the prevalence and comorbidity of current mental disorders defined by DSM-III-R among elderly suicide victims and to compare them with the mental disorders among younger victims. Using a psychological autopsy method, we collected comprehensive data on all suicides in Finland during 1 year. Retrospective Axis I-III consensus diagnoses were assigned to a random sample consisting of 43 victims aged 60 years or over and 186 victims aged under 60 from the nationwide suicide population. At least one Axis I diagnosis was made for 91% of the elderly victims. Major depression as the principal diagnosis was more common among the elderly victims. Almost all elderly female victims were major depressives. Psychiatric comorbidity was more common among elderly male than among elderly female victims. More of the elderly victims (88%) than the younger (36%) received Axis III diagnoses. Suicide among the elderly without a diagnosable mental disorder and somatopsychiatric comorbidity seems to be rare.     

Status of the teeth and degree of care in handicapped in Flanders

In general, handicapped 12-year old do not show statistical relevant differences with non-handicapped age-matched children in Flanders regarding general caries prevalence, caries distribution and total caries experience. However, important differences were found for the restorative index showing a higher caries treatment need in handicapped children. When the results were analysed according to the type of handicapping condition, it was seen that children with borderline and mild mental handicap and children with speech-, language and/or learning difficulties show the most unfavorable picture. They have a high caries prevalence and caries experience and a low restorative index. Additional analysis of the results can throw some light on the presence of additional caries risk indicators and contributing caries risk factors.     

Efficacy and safety of adenosine in diagnosis and treatment of regular tachycardia in the elderly

BACKGROUND: Adenosine is currently used in the treatment and differential diagnosis of regular tachycardia. However, the efficacy of its employment has not been studied in elderly people. METHODS: We evaluated the safety, and the diagnostic and therapeutic utility of adenosine in elderly people aged over 70 years with regular sustained tachycardia, compared with a group of patients aged under 70 years affected by the same arrhythmia. Adenosine was given to 107 patients in increasing bolus doses up to 18 mg during regular broad and narrow complex tachycardia; 49 patients were aged 70 and over, and 58 patients were aged less than 70 years. In the former group, surface ECG showed 38 narrow complex tachycardias and 11 broad complex ones; in the second group there were 48 narrow complex tachycardias and 10 broad complex ones. RESULTS: Adenosine was effective in 94% of the elderly patients and in 93% of the younger patients. In the group aged over 70 years, adenosine restored sinus rhythm in 37% of patients and revealed the mechanism of arrhythmia in 57%. Adenosine restored sinus rhythm in 50% of patients under 70 years and revealed atrial or sinus tachycardia in 43%. The incidence of symptomatic side effects and peri-conversion ventricular arrhythmias was similar in the two groups. There were ventricular pauses over 3 s long in four (8%) of the older patients (maximum pause 7 s) and in two patients (3%) of the group under 70 years (maximum pause 6 s). No adverse haemodynamic effects were observed. CONCLUSION: These data demonstrate the safety and the value of adenosine in the diagnosis and treatment of regular tachycardia in elderly patients.     

Evaluation of changes in primary health care availability and provision from the patient perspective

This study was designed to investigate changes in primary care following recent NHS reforms. The study was carried out by home interview of random samples of people aged 65 years and over in three district health authorities; 1500 in 1990 and 1500 in 1992, before and after the introduction of the reforms. The response rate was 94% (1413 in 1990 and 1405 in 1992). Few patients (6%) changed their general practitioner (GP) in 1990 or 1992. There was an increase in the provision of written practice information in 1992, but more than 60% of patients could not recall receiving leaflets. More practices included practice nurses and appointments systems and fewer used rotas of local practices or deputizing services for 'out of hours' calls. In 1992 more patients aged 75 years and over saw their GP within the previous year and significantly more were assessed for vision, hearing, continence, foot problems and blood pressure and had their urine tested, but most of these health assessments, except blood pressure (64%), were recalled by few patients. There have been small changes in the provision and use of primary health care by older people since the introduction of the new GP contract.     

Acknowledgement of handicap as a tactic in social interaction.

Nonhandicapped people often report discomfort and uncertainty when interacting with handicapped individuals. Three studies, using a total of 160 nonhandicapped undergraduates, investigated a possible tactic that handicapped people could use to reduce a fellow interactant's discomfort and uncertainty. Ss watched 2 videotapes of handicapped individuals being interviewed. Ss then chose the handicapped person with whom they would prefer to work on a cooperative task. Results of all 3 studies support the hypothesis that a handicapped person who acknowledges the handicap will be preferred to a handicapped person who does not. In Study 1, Ss significantly preferred a handicapped person who acknowledged the handicap to a handicapped person who did not disclose anything personal. In Study 2, Ss significantly preferred an acknowledging person over one who made a personal disclosure other than about the handicap. In Study 3, Ss preferred the individual acknowledging a handicap over one who disclosed something else personal even when the acknowledging individual was clearly nervous about doing so. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between socioeconomic status, employment, and health during economic change, 1973-93

OBJECTIVE: To investigate the association between the national unemployment rate and class differences in the relation between health and employment during the period 1973-93. DESIGN: Data from general household surveys, 1973-93. Comparison of rates of employment, unemployment, and economic inactivity among those with and without limiting longstanding illness in different socioeconomic groups and how these varied over 20 years. SUBJECTS: All men aged 20-59 years in each survey between 1973 and 1993. MAIN OUTCOME MEASURES: Change over time in class specific rates of employment, unemployment, and economic inactivity in those with and without limiting longstanding illness. RESULTS: Men in socioeconomic groups 1 and 2 with no longstanding illness experienced little decrease in their chances of being in paid employment as the general unemployment rate rose. Those most affected were men in manual groups with limiting longstanding illness. The likelihood of paid employment was affected far less by such illness in non-manual than in manual groups. In group 1 about 85% of men with such illness were in paid employment in 1979 and 75% by 1993; in group 4 the equivalent proportions were 70% and 40%. In men in manual groups with limiting longstanding illness there was no sign of employment rates rising again as the economy recovered. CONCLUSION: Socioeconomic status makes a large difference to the impact of illness on the ability to remain in paid employment, and this impact increases as unemployment rises. Men with chronic illness in manual occupations were not drawn back into the labour force during the economic recovery of the late 1980s.     

Employment status influences the weekly patterns of suicide among alcohol misusers

As part of the National Suicide Prevention Project in Finland, a nationwide psychological autopsy study, all suicide victims (n = 1397) over a 12-month period were investigated concerning factors associated with any variation in suicide frequency between weekdays and weekends. In particular, employment status was expected to have influenced the weekly pattern of alcohol misuse, and thereby to have caused clustering of suicides at weekends among the employed. Among suicide victims who had misused alcohol, those in employment were significantly more likely to have committed suicide during the weekend that those without work (52% vs. 34%, p < 0.001). In logistic regression analysis, employment was the only independent variable significantly associated with suicide at the weekend. According to forensic chemical analysis, those classified as misusers had frequently used alcohol at the time of suicide, regardless of the weekday, and slightly more often if employed. The clustering of suicides at weekends among employed alcohol misusers is probably explained by a weekly pattern in the use of alcohol, which suggests that besides the established risk factors for suicide among alcohol misusers, the act of using alcohol per se also contributes to the suicidal act.     

Cataract surgery in a patient with severe chronic iritis and corneal endothelial damage

OBJECTIVES: (1) To assess the prevalence and the consequences of chronic verbal aggression, physical aggression, financial mistreatment, and neglect in a community-based sample; (2) to investigate the circumstances that led to the abuse and the ways in which the victims handled the problem. DESIGN: Prevalence was assessed in a population-based sample of 1797 older people living independently in Amsterdam, the Netherlands. In a follow-up study 1 year later, the victims were questioned again about the background and consequences of the abuse. RESULTS: The 1-year prevalence of elder abuse was 5.6%. The prevalence of the various types of elder abuse was: verbal aggression 3.2%, physical aggression 1.2%, financial mistreatment 1.4%, and neglect 0.2%. Most victims reported emotional reactions immediately after the abuse. Seven of 36 victims experienced physical or financial damage as a consequence of the abuse. More than 70% of the victims were able to stop the abuse, either by themselves or with the help of others. CONCLUSION: The rate of occurrence and the consequences of elder abuse in the Netherlands was established. Elder abuse is more widely spread if not only close relatives or people with whom the older person lives are considered as possible perpetrators but other familiar and trusted people are considered as well. Intervention should be focused on the roughly 40% of victims who were not able to stop the abuse.     

Partners of survivors of abuse: A men's therapy group.

This article describes a therapy group for the male partners of women in treatment for sexual or physical abuse. The partners came to see themselves as the secondary victims of the original abuse as their relationships and families were disturbed for long periods during their wives' treatment. The group validated the men's experiences, gave them an emotional outlet, educated them about their wives' dynamics, and assisted them in sustaining their relationships. This article presents a typical profile and specific outcomes gathered from 16 participants (aged 37–52 yrs) over a 4.5 yr period and describes the therapeutic approach. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The alcoholized pedestrian as victim of fatal traffic accidents (author's transl)

The following results were obtained in an analysis of the road accidents which occurred in Vienna and its environs over the past ten years with a fatal outcome for the involved pedestrians: 39.3% of the pedestrains who died in an accident had a blood alcohol concentration of at least 0.8%, the average amounting to 2.15%. As many as 60.2% of the male victims were alcoholized, whereas only 7.6% of the women were alcoholized. The female victims were mostly elderly, 86% being older than 60 years, whereas many of the male victims were middle-aged. These middle-aged male pedestrians were frequently drunk; among the men aged between 40 and 49 the rate of alcoholization soared to 88%. The peak time of fatal traffic accidents involving alcoholized pedestrians lies in the hours before midnight. The number of pensioners among the sober victims is raised in comparison with the population rate, whilst an unexpectedly high percentage of unskilled workers found in the alcoholized group. In 7.6% of the alcoholized victime the autopsy revealed cirrhosis of the liver; 27.1% had fatty degeneration of the liver. Nearly as many female pedestrians met with a fatal road accident as males within the city boundaries. Accordingly, the percentage of alcoholized victims in the city (31.7%) is low compared with the rural areas, where about 60% of the victims had a blood alcohol concentration of at least 0.8%.     

Counseling victims of sexual harassment.

Describes therapeutic experiences with 10 sexual harassment victims in individual therapy and 7 sexual harassment victims in group therapy and compares them with data from sexual employment surveys and with other crime populations. Findings reveal that victims progressed through stages of feelings including confusion/self-blame, fear/anxiety, depression/anger, and disillusionment. The stress of sexual harassment was also affected by a history of prior victimization and by the victim's involvement in a formal complaint process related to the harassment. The group setting was found to be more effective than individual treatment for coping with the specific effects of sexual harassment, and Ss in group therapy used the group to understand their experience, sort through legal and employment decisions, learn new coping skills, and develop support for each other. Victims of sexual harassment differed from victims of crime: The primary effects of the harassment were on economic and career well-being; the secondary effects were on private relationships and physical well-being. The reverse is true for victims of crime. Therapeutic complications arising from the therapist's involvement in court proceedings and organizational remedies are also described. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Avoidance of the handicapped: An attributional ambiguity analysis.

Conducted 2 experiments with a total of 64 undergraduates to demonstrate a general strategy for detecting motives that people wish to conceal. The strategy involves having people choose between 2 alternatives, one of which happens to satisfy the motive. By counterbalancing which one does so, it is possible to distill the motive by examining the pattern of choice that people make. The motive employed was the desire to avoid the physically handicapped. It was predicted that because most people would not wish to reveal this desire, they would be more likely to act on it if they could appear to be choosing on some other basis. Results show that Ss avoided the handicapped more often if the decision to do so was also a decision between 2 movies and avoidance of the handicapped could masquerade as a movie preference. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Large-cell change of hepatocytes in cirrhosis may represent a reaction to prolonged cholestasis

The deaths of 10 heroin body packers are reported and contrasted to those of cocaine body packers. Only one was a woman, and all were traveling to or from Colombia. Drug packets deteriorated in the gastrointestinal tract and caused the deaths of eight victims. Accomplices removed drug packets from two of these smugglers after death occurred. One died of peritonitis stemming from a small-bowel obstruction caused by the drug packets, and one died from the recreational use of heroin (nasally ingested). The heroin recovered was < or = 881 g, and the drug purity of the contraband in three cases was between 65% and 73%. Blood concentrations of morphine were < 1.0 mg/L in four victims; no morphine was detected in the smuggler who died of peritonitis. However, two victims had blood morphine concentrations of 4.4 mg/L and 6.7 mg/L, respectively, and three had morphine concentrations of 35.8, 39.4, and 52.6 mg/L, respectively. Fatal heroin body packing differs from cocaine body packing in that individuals may have extremely high drug levels in their blood and their accomplices appear to be more likely to abandon them in a remote location after attempting to remove the drug packets after death has occurred.     

Prevalence of enteropathogenic and enterotoxigenic Escherichia coli in children with and without diarrhoea in Esteli, Nicaragua

OBJECTIVE: To assess some of the employment experiences of people with diabetes mellitus and to compare their experiences with those of a non-diabetic sibling control group. DESIGN: A questionnaire about employment experiences was administered to diabetic subjects aged 16-39 years, and an abbreviated questionnaire was administered to their eligible siblings. SETTING: The Illawarra area of New South Wales. PARTICIPANTS: The names of diabetic subjects were obtained from the Illawarra diabetes register. RESULTS: Interviews were conducted with 184 of 226 (81.4%) eligible diabetic subjects and with 70 eligible siblings. There were no significant differences between the diabetic subjects and their siblings with respect to educational achievements and rates of employment. Siblings reported a mean of 2.6 days sickness absenteeism in the year prior to the survey. Diabetics were absent from work for a mean of 4.5 days for reasons not related to their diabetes and for a mean of 2.6 days for diabetic causes. Within the diabetic group, 50% felt that having diabetes would make it more difficult to find another job, 33.7% felt that diabetes would influence their search for alternative employment and 19.6% felt that at some stage they had been refused employment because of their diabetes. Fifteen per cent of diabetics were aware of an example of discrimination and 24.2% of diabetics in employment had at some stage tried to hide their diagnosis from their employer. CONCLUSIONS: Diabetics do not appear disadvantaged compared with their siblings with respect to employment participation but are more likely to be absent from work due to sickness. However, many diabetic subjects had experienced a job refusal, had tried to hide their diagnosis from employers, were aware of examples of discrimination and were very negative about future employment prospects.     

A randomised controlled trial of a dietary advice program for relatives of heart attack victims

OBJECTIVE: To compare two interventions for reducing dietary fat intake in first degree relatives of recent heart attack victims. DESIGN: A randomised controlled trial comparing a low cost mail-out advice program; referral to a general practitioner (GP); and no intervention (control group). PARTICIPANTS: Adult children or siblings, aged less than 70 years, of survivors of definite or suspected heart attack who had been admitted to hospitals in the Lower Hunter Region of New South Wales. MAIN OUTCOME MEASURES: Dietary fat intake (evaluated with a validated short questionnaire) and measurement of blood cholesterol levels at six months. RESULTS: Of the 342 relatives who participated (36% of those invited), 109, 120 and 113, respectively, were randomly assigned to receive a mail-out intervention, advice from their GP or to be part of a control group. The six-month follow-up questionnaire was completed by only 59% of those in the mail-out intervention group compared with 71% of the GP group and 77% of the control group. Younger participants, cigarette smokers and children (compared with siblings) were less likely to return a follow-up questionnaire. The mail-out group showed a statistically significant 20% reduction in self-reported dietary fat intake, but this was not seen in either the GP group or the controls. The low response rate meant the study had insufficient power to detect hypothesised changes in blood cholesterol. CONCLUSION: Because of the poor response rate and possible biases from a differential response to follow-up, we conclude that this low intensity intervention for relatives of people with recent heart attack produces only a modest improvement in reported dietary fat intake. Alternative strategies may be more effective in reducing the risk of heart disease.     

Consenting and consulting for cosmetic surgery

BACKGROUND: The number of aged people is increasing. It is conceivable that we will be treating considerably more aged patients with more surgical risk factors in the very near future. METHODS: During the period between 1976 and 1996, 212 patients of 80 years of age and older underwent skin surgery at the Mie University Hospital, Japan. Among them, 25 patients of 90 years of age and over were studied. RESULTS: Fourteen patients (56.0%) have undergone skin surgery in the past 5 years; 22 patients (88.0%) had skin tumors on the face and ears; squamous cell carcinoma was found in 17 patients (68.0%), while basal cell carcinoma was seen in four patients (16.0%). Despite their advanced ages, half of the patients had no medical contraindications to performing surgery. CONCLUSIONS: Careful preoperative management may allow more cutaneous surgery to be carried out in aged people.     

Health, health promotion and the elderly

Health promotion is a mode of practice which is being increasingly examined by policymakers (DHSS, 1987; DoH, 1992). Although practitioners are being required to screen people over 75 years of age and are exhorted to reduce accidents in the elderly by 33% between 1990 and 2005 (DoH, 1992), there is evidence that they do not value this sort of work (Pursey & Luker, 1993). This paper looks at the findings from 178 interviews with people aged over 75 years, examining the importance of health and health promotion to the elderly. Further to the work of Cox et al. (1987), it is clear that people aged over 75 years continue to engage in a wide variety of activities which are designed to keep or improve their health. Elderly people's accounts of their health suggest that the real influence of social circumstances and environment must be assessed and planned for if health promotion activity is to have relevance and meaning to this group of people. Evidence is presented which indicates that the elderly are a group of people who would welcome health-promotion activity provided it is given in easily accessible forms. The notion of client participation is highlighted as a difficult area, which is likely to require particular skill in working with elderly clients. In the light of these findings, practitioners may need to examine their own attitudes to their work with the elderly.     

Home observations of mothers and sibling dyads comprised of Down's syndrome and nonhandicapped children.

Observed interaction in 31 mother–child–child triads in which 1 of the children had Down""s syndrome. Down""s syndrome siblings were all aged 18–117 mo, nonhandicapped siblings were aged 12–132 mo, and mothers were aged 30–46 yrs. Mothers were more positive and directive toward their children with Down""s syndrome but received more positive initiations from their nonhandicapped children. Significant reciprocity between mother and child was found in dyads with a handicapped child but not in dyads with a nonhandicapped child. The handicapped child""s negative behavior toward the sibling was the most important predictor of interaction across the triad. Individual differences in the social behavior of children with Down""s syndrome may have an impact throughout family systems. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Melanoblastoma of the rectum

Vroom's (1964) expectancy theory model was used to predict older workers' choices between continued employment or immediate retirement. It was hypothesized that a person's preference for one of the two alternatives would be a function of the differences between the instrumentality of employment and the instrumentality of retirement for the attainment of outcomes, multiplied by the valence of each outcome, summed over outcomes. To test this, 290 Israeli male workers, aged 57 to 64, were interviewed. Measures included: preference for employment or retirement; valences of 35 outcomes; perceived instrumentalities of employment and retirement. The results supported the hypothesis (R = .40; p less than .01). It is suggested that further research along these lines could equip organizations with a tool for assisting older employees in the transition to retirement or for encouraging those who are still capable of making a significant contribution to remain employed.