Do housing tenure and car access predict health because they are simply markers of income or self esteem? A Scottish study.
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OBJECTIVE: To investigate relations between health (using a range of measures) and housing tenure or car access; and to test the hypothesis that observed relations between these asset based measures and health are simply because they are markers for income or self esteem. DESIGN: Analysis of data from second wave of data collection of West of Scotland Twenty-07 study, collected in 1991 by face to face interviews conducted by nurse interviewers. SETTING: The Central Clydeside Conurbation, in the West of Scotland. SUBJECTS: 785 people (354 men, 431 women) in their late 30s, and 718 people (358 men, 359 women) in their late 50s, participants in a longitudinal study. MEASURES: General Health Questionnaire scores, respiratory function, waist/hip ratio, number of longstanding illnesses, number of symptoms in the last month, and systolic blood pressure; household income adjusted for household size and composition; Rosenberg self esteem score; housing tenure and care access. RESULTS: On bivariate analysis, all the health measures were significantly associated with housing tenure, and all except waist/hip ratio with car access; all except waist/hip ratio were related to income, and all except systolic blood pressure were related to self esteem. In models controlling for age, sex, and their interaction, neither waist/hip ratio nor systolic blood pressure remained significantly associated with tenure or care access. Significant relations with all the remaining health measures persisted after further controlling for income or self esteem. CONCLUSIONS: Housing tenure and car access may not only be related to health because they are markers for income or psychological traits; they may also have some directly health promoting or damaging effects. More research is needed to establish mechanisms by which they may influence health, and to determine the policy implications of their association with health. (+info)
Biomarkers for exposure to ambient air pollution--comparison of carcinogen-DNA adduct levels with other exposure markers and markers for oxidative stress.
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Human exposure to genotoxic compounds present in ambient air has been studied using selected biomarkers in nonsmoking Danish bus drivers and postal workers. A large interindividual variation in biomarker levels was observed. Significantly higher levels of bulky carcinogen-DNA adducts (75.42 adducts/10(8) nucleotides) and of 2-amino-apidic semialdehyde (AAS) in plasma proteins (56.7 pmol/mg protein) were observed in bus drivers working in the central part of Copenhagen, Denmark. In contrast, significantly higher levels of AAS in hemoglobin (55.8 pmol/mg protein), malondialdehyde in plasma (0. 96 nmol/ml plasma), and polycyclic aromatic hydrocarbon (PAH)-albumin adduct (3.38 fmol/ microg albumin) were observed in the suburban group. The biomarker levels in postal workers were similar to the levels in suburban bus drivers. In the combined group of bus drivers and postal workers, negative correlations were observed between bulky carcinogen-DNA adduct and PAH-albumin levels (p = 0.005), and between DNA adduct and [gamma]-glutamyl semialdehyde (GGS) in hemoglobin (p = 0.11). Highly significant correlations were found between PAH-albumin adducts and AAS in plasma (p = 0.001) and GGS in hemoglobin (p = 0.001). Significant correlations were also observed between urinary 8-oxo-7, 8-dihydro-2'-deoxyguanosine and AAS in plasma (p = 0.001) and PAH-albumin adducts (p = 0.002). The influence of the glutatione S-transferase (GST) M1 deletion on the correlation between the biomarkers was studied in the combined group. A significant negative correlation was only observed between bulky carcinogen-DNA adducts and PAH-albumin adducts (p = 0.02) and between DNA adduct and urinary mutagenic activity (p = 0.02) in the GSTM1 null group, but not in the workers who were homozygotes or heterozygotes for GSTM1. Our results indicate that some of the selected biomarkers can be used to distinguish between high and low exposure to environmental genotoxins. (+info)
Urban-rural comparisons of drink-driving behaviour among late teens: a preliminary investigation.
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A preliminary study was conducted to examine the nature and extent of urban-rural differences in self-reported drinking and driving among youths in Western Australia. A total of 102 youths aged 17, 18 and 19 years were surveyed via a random street sampling technique about their alcohol consumption and drink-driving behaviour. Analyses indicated that urban youths had a significantly higher level of self-reported drink-driving behaviour than their rural counterparts. Males indicated a higher level of self-reported drink-driving behaviour than females. This article also provides a review and summary of youth drink-driving literature with special focus on urban-rural comparisons. (+info)
Considerations in pharmaceutical conversion: focus on antihistamines.
(4/1390)
The practice of pharmaceutical conversion, which encompasses three types of drug interchange (generic, brand, and therapeutic substitution), is increasing in managed care settings. Pharmaceutical conversion has numerous implications for managed care organizations, their healthcare providers, and their customers. Although drug cost may be a driving consideration in pharmaceutical conversion, a number of other considerations are of equal or greater importance in the decision-making process may affect the overall cost of patient care. Among these considerations are clinical, psychosocial, and safety issues; patient adherence; patient satisfaction; and legal implications of pharmaceutical conversion. Patient-centered care must always remain central to decisions about pharmaceutical conversion. This article discusses the issues related to, and implications of, pharmaceutical conversion utilizing the antihistamines class of drugs as the case situation. (+info)
Simple reaction time, duration of driving and sleep deprivation in young versus old automobile drivers.
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Car accidents are one of the major causes of death in modern society and sleepiness is identified as one major risk factor. The purposes of the present study were: (1) to relate the sleep loss and driving time to a performance indicator and (2) to identify risk factors of performance decrement. We investigated 294 drivers (age < 30 years, n = 100; age > or = 30 years, n = 194) who drove into a rest stop area. All were asked to fill out a questionnaire about the drive and previous sleep/wake pattern, and to carry out a 10 min, simple reaction time (RT) test. The level of performance is identified by the 10% slowest RTs. Multiple regression analysis, with the mean of the 10% Slowest RTs as the dependent variable, showed that age, duration of drive, and duration (shortness) of previous breaks were the main predictors. Our study suggests that public awareness may need to be raised with respect excessive length of driving, especially in young drivers. (+info)
A survey of attitudes and knowledge of geriatricians to driving in elderly patients.
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OBJECTIVE: To assess the attitudes of consultant members of the British Geriatrics Society to elderly patients driving motor vehicles. DESIGN: An anonymous postal survey assessing knowledge and attitudes to driving in elderly people. A standardized questionnaire was used and five case histories were offered for interpretation. SETTING: The study was co-ordinated from a teaching hospital. SUBJECTS: The 709 consultant members of the British Geriatrics Society. Four hundred and eighteen responses were obtained, which represents a 59% response rate. RESULTS: 275 Respondents (68%) correctly realised that a person aged 70 had a duty to inform the Driving and Vehicle Licensing Authority (DVLA) about their eligibility to drive. The remainder did not. Most (315; 75%) believed that the overall responsibility for informing the DVLA was with the patient. If a patient was incapable of understanding advice on driving because of advanced dementia, 346 (83%) would breach patient confidentiality and inform the authority directly. Where a patient was fully capable of understanding medical advice but ignored it, 72% of geriatricians would have legitimately breached patient confidentiality and informed the DVLA. Most geriatricians (88%) saw their main role as one of providing advice on driving to patients and their families. Enforcing DVLA regulations was not seen as an appropriate function, unless the patient was a danger to themselves or other drivers. CONCLUSIONS: There is a wide variation in knowledge of driving regulations and attitudes to driving in elderly patients. Better education of geriatricians should improve awareness of when elderly drivers can safely continue to drive. (+info)
The effects of age and alcohol intoxication on simulated driving performance, awareness and self-restraint.
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AIMS: To investigate whether, compared with middle-aged men (aged 30-50), older men (age > or =60) (i) perform more poorly on a driving simulator and (ii) are more sensitive to the effects of ethanol in terms of blood alcohol concentration (BAC) and driving performance, but more aware of their driving difficulties, and therefore exercise better driving judgement. METHODS: 14 Healthy middle-aged men (mean age 36 years) were compared with 14 healthy older men (mean age 69 years) on an interactive driving simulator, while sober and while legally intoxicated (BAC >80 mg/dl). RESULTS: Older age was associated with poorer driving performance on the simulator. While sober, older men exhibited more improper braking, slower driving, greater speed variability, fewer appropriate full stops and more crashes, and spent more time executing left turns (across oncoming traffic); all values < or =0.02. BACs > or =80 mg/dl were associated with impaired driving, with more inappropriate braking, fewer appropriate full stops and more time executing left turns (all values > or =0.02) and trends towards more speed variability, more low speed collisions and more wrong turns (values <0.1). However, similar ethanol consumption did not produce higher peak BAC or more driving impairments in older drivers. While there were no differences between age groups in terms of awareness of intoxication or driving difficulties, older men were unwilling to drive while legally intoxicated because of fear of physical injury, whereas middle-aged men were more likely to avoid driving when intoxicated due to fear of legal ramifications. CONCLUSION: While both age and legal intoxication affected driving performance, older men were no more sensitive to ethanol in terms of peak BACs, driving performance or awareness/judgement than middle-aged men. (+info)
Drinking and driving among US high school seniors, 1984-1997.
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OBJECTIVES: This article reports the prevalence of, and trends in, driving after drinking and riding in a car with a driver who has been drinking among American high school seniors, based on data from more than a decade (1984-1997) of annual national surveys. METHODS: Logistic regressions were used to assess the effects of demographic factors (gender, region of country, population density, parental education, and race/ethnicity) and selected "lifestyle" factors (religious commitment, high school grades, truancy, illicit drug use, evenings out per week, and miles driven per week). RESULTS: Rates of adolescent driving after drinking and riding with a driver who had been drinking declined significantly from the mid-1980s to the early or mid-1990s, but the declines have not continued in recent years. Rates of driving or riding after drinking were higher among high school seniors who are male. White, living in the western and northeastern regions of the United States, and living in rural areas. Truancy, number of evenings out, and illicit drug use all related significantly positively with the dependent variables, whereas grade point average and religious commitment had a negative relationship. Miles driven per week related positively to driving after drinking. (+info)