(1/89) Prevalence of sleep disturbance and hypnotic medication use in relation to sociodemographic factors in the general Japanese adult population.
This study was the first nationwide population-based study to estimate the prevalence rates of sleep disturbance and hypnotic medication use in the general Japanese adult population. In 1997, 2,800 Japanese adults aged 20 years and over were randomly selected from the 1995 Census and 1,871 were examined using the Pittsburgh Sleep Quality Index. The respective estimated overall prevalences of insomnia (INS), difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), poor perceived quality of sleep (PQS) and hypnotic medication use (HMU) were 17.3%, 8.6%, 12.9%, 17.8%, and 3.5% in males and 21.5%, 12.6%, 16.2%, 20.2% and 5.4% in females. Among males, DIS (OR = 2.76) and PQS (OR = 2.12) were associated with never having married. DMS was associated with being 60 years and older (OR = 2.68) or divorced/separated (OR = 3.74). Among females, DMS was associated with being widowed (OR = 1.65), unemployed (OR = 1.60), 40 to 59 years old (OR = 0.57) or never having married (OR = 0.39). DIS was associated with being widowed (OR = 1.67) or unemployed (OR = 1.58). HMU was associated with advancing age (OR = 8.26-10.7), being widowed (OR = 2.12) or never having married (OR = 2.84). PQS was associated with advancing age (OR = 0.63-0.50). Our study showed sleep disturbance and hypnotic medication use were prevalent among Japanese adults and some sociodemographic factors contributed to them. (+info)
(2/89) Risk factors for active syphilis and TPHA seroconversion in a rural African population.
OBJECTIVES: Syphilis is an important cause of morbidity in sub-Saharan Africa, and a cofactor for the sexual transmission of HIV. A better understanding of the prevalence and risk factors of syphilis in African populations would help to formulate effective interventions for its prevention and treatment. METHODS: The prevalence and incidence of syphilis were obtained from a cohort recruited in Mwanza, Tanzania. Two unmatched case-control studies nested within the cohort provide information on potential risk factors. RESULTS: The prevalence of active syphilis (TPHA positive and RPR positive any titre) was 7.5% in men and 9.1% in women, but in youths (aged 15-19 years) the prevalence was higher in women (6.6%) than in men (2.0%). The incidence of TPHA seroconversion was highest in women aged 15-19 at 3.4% per year, and around 2% per year at all ages among men. A higher prevalence of syphilis was found in those currently divorced or widowed (men: OR=1.61, women: OR=2.78), and those previously divorced or widowed (men: OR=1.51, women: OR=1.85). Among men, prevalence was associated with lack of circumcision (OR=1.89), traditional religion (OR=1.55), and reporting five or more partners during the past year (OR=1.81) while incidence was associated with no primary education (OR=2.17), farming (OR=3.85), and a self perceived high risk of STD (OR=3.56). In women, prevalence was associated with no primary education (OR=2.13), early sexual debut (OR=1.59), and a self perceived high risk of STD (OR=3.57), while incidence was associated with living away from the community (OR=2.72). CONCLUSION: The prevalence and incidence of syphilis remain high in this rural African population. More effort is needed to promote safer sexual behaviour, and to provide effective, accessible treatment. The high incidence of syphilis in young women calls for sexual health interventions targeted at adolescents. (+info)
(3/89) Spousal bereavement--implications for health.
BACKGROUND: Bereavement is a potential medical problem as it has implications for health through possible associations with morbidity and mortality. OBJECTIVE: The aim of the present study was to ascertain if spousal bereavement is associated with physical and psychological parameters of illness. METHODS: A spousal bereavement register was created at a village general practice in the West Midlands of 122 spouses (4.9% of the practice population). After exclusion of 22, a sample of 100 had their medical records analysed for the periods of 12 months before and after bereavement. RESULTS: Between these two periods, the average number of consultations increased from 5.99 to 7.60 (P = 0.01), where the vast majority were for physical illness. Mean number of prescriptions increased from 8.54 to 9.15 per patient (P = 0.8) for physical illness and from 0.76 to 1.34 (P = 0.09) for psychological illness. CONCLUSION: Bereavement can be viewed as a medical problem, but this is not borne out in prescribing and so care should be taken not to over-medicalize grief. (+info)
(4/89) Factors associated with HIV infection are not the same for all women.
STUDY OBJECTIVES: To determine if factors associated with HIV infection vary between subpopulations of women resident in Great Britain. DESIGN: Case-control analyses on already existing datasets. SETTING: Great Britain. PARTICIPANTS: 317 cases selected from a MRC Collaborative Study of HIV Infection in Women and 3635 controls selected from a National Survey of Sexual Attitudes and Lifestyles. MAIN RESULTS: Factors associated with HIV infection varied among subpopulations of women. Among women heterosexually infected, factors associated with HIV infection were residence in London (odds ratio (OR) = 8.3; 95% confidence intervals (CI) 4.6 to 14.9), widowhood (OR = 47.6; CI 20.0 to 113.1), being black (OR = 25.2; CI 15.6 to 40.8) and particularly among white women, having 10 or more sexual partners (OR = 14.5; CI 5.1 to 41.3). Young age was important for black women heterosexually infected. Among women who shared needles, residence in London (OR = 19.0; CI 5.8 to 62.6) or Scotland (OR = 26.9; CI 8.0 to 90.4) and large numbers of sexual partners was important (OR = 19.6; CI 6.4 to 60.0); termination of pregnancy history was also important for those with fewer than 10 sexual partners (OR = 6.7; CI 3.4 to 13.1); and low social class was important for those with 10 or more sexual partners (OR = 4.1; CI 1.7 to 9.6). CONCLUSIONS: Factors vary in importance and significance of association with HIV infection in different subpopulations of women resident in Great Britain. This diversity is also likely to occur in other populations. It is important to identify these differences between subpopulations. Prevention and control policies and activities for HIV/AIDS cannot treat all women as if they were the same. (+info)
(5/89) The unrecognised cost of cancer patients' unrelieved symptoms:a nationwide follow-up of their surviving partners.
We investigated if a cancer patient's unrelieved symptoms during the last 3 months of life increase the risk of long-term psychological morbidity of the surviving partner. All women (n=506) living in Sweden under 80 years of age, who lost their husband/partner owing to cancer of the prostate in 1996 or of the urinary bladder in 1995 or 1996 were asked to answer an anonymous postal questionnaire, 2-4 years after their loss. The widows' psychological morbidity was associated with the patient's unrelieved mental symptoms. When the patient was perceived to have been very anxious during last three months of life (compared to no observed symptoms) the relative risks for the widows' psychological morbidity were: 2.5 (1.4-4.3) for depression and 3.4 (1.4-8.2) for anxiety. When comparing reports of the patient's pain (much vs no), the relative risks were 0.8 (0.5-1.2) for widowhood depression, and 0.8 (0.4-1.7) for widowhood anxiety. The patients were found to have had adequate access to physical pain control but poor access to psychological symptom control. Efficiency in diagnosing and treating psychological complications of terminally ill cancer patients may not only improve their quality of life but possibly also prevent long-term psychological morbidity of their surviving partners. (+info)
(6/89) Suicide and marital status in the United States, 1991-1996: is widowhood a risk factor?
OBJECTIVES: This study examined whether marital status is associated with suicide rates among various age, sex, and racial groups, in particular with widowhood among young adults of both sexes. METHODS: US national suicide mortality data were compiled for the years 1991-1996, and suicide rates were broken down by race, 5-year age groups, sex, and marital status. RESULTS: Data on suicide rates indicated an approximately 17-fold increase among young widowed White men (aged 20-34 years), a 9-fold increase among young widowed African American men, and lesser increases among young widowed White women compared with their married counterparts. CONCLUSIONS: National data suggest that as many as 1 in 400 White and African American widowed men aged 20-35 years will die by suicide in any given year (compared with 1 in 9000 married men in the general population). (+info)
(7/89) Is posthumous semen retrieval ethically permissible?
It is possible to retrieve viable sperm from a dying man or from a recently dead body. This sperm can be frozen for later use by his wife or partner to produce his genetic offspring. But the technical feasibility alone does not morally justify such an endeavour. Posthumous semen retrieval raises questions about consent, the respectful treatment of the dead body, and the welfare of the child to be. We present two cases, discuss these three issues, and conclude that such requests should generally not be honoured unless there is convincing evidence that the dead man would want his widow to carry and bear his child. Even with consent, the welfare of the potential child must be considered. (+info)
(8/89) Somatic panic-attack equivalents in a community sample of Rwandan widows who survived the 1994 genocide.
The present study is the first to attempt to determine rates of panic attacks, especially 'somatically focused' panic attacks, panic disorder, symptoms of post-traumatic stress disorder (PTSD), and depression levels in a population of Rwandans traumatized by the 1994 genocide. The following measures were utilized: the Rwandan Panic-Disorder Survey (RPDS); the Beck Depression Inventory (BDI); the Harvard Trauma Questionnaire (HTQ); and the PTSD Checklist (PCL). Forty of 100 Rwandan widows suffered somatically focused panic attacks during the previous 4 weeks. Thirty-five (87%) of those having panic attacks suffered panic disorder, making the rate of panic disorder for the entire sample 35%. Rwandan widows with panic attacks had greater psychopathology on all measures. Somatically focused panic-attack subtypes seem to constitute a key response to trauma in the Rwandan population. Future studies of traumatized non-Western populations should carefully assess not only somatoform disorder but also somatically focused panic attacks. (+info)