Average household income, crime, and smoking behaviour in a local area: the Finnish 10-Town study

Social environments, like neighbourhoods, are increasingly recognised as determinants of health. While several studies have reported an association of low neighbourhood socio-economic status with morbidity, mortality and health risk behaviour, little is known of the health effects of neighbourhood crime rates. Using the ongoing 10-Town study in Finland, we examined the relations of average household income and crime rate measured at the local area level, with smoking status and intensity by linking census data of local area characteristics from 181 postal zip codes to survey responses to smoking behaviour in a cohort of 23,008 municipal employees. Gender-stratified multilevel analyses adjusted for age and individual occupational status revealed an association between low local area income rate and current smoking. High local area crime rate was also associated with current smoking. Both local area characteristics were strongly associated with smoking intensity. Among ever-smokers, being an ex-smoker was less likely among residents in areas with low average household income and a high crime rate. In the fully adjusted model, the association between local area income and smoking behaviour among women was substantially explained by the area-level crime rate. This study extends our knowledge of potential pathways through which social environmental factors may affect health.     

Awareness of breast and cervical cancer risk factors and screening behaviours among nurses in rural region of Turkey

Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but actually they are largely preventable diseases. There is limited data on breast and cervical cancer knowledge, screening practices and attitudes of nurses in Turkey. A self-administered questionnaire was used to investigate the knowledge and attitude of nurses on risk factors of the breast and cervical cancer as well as screening programmes such as breast self-examination (BSE), clinical breast examination, mammography (MMG) and papanicolaou (pap) smear test. In total, 125 out of 160 nurses participated in the study (overall response rate was 80.6%). The risk factors and symptoms of breast cancer was generally well known, except for early menarche (23.2%) and late menopause (28.8%). For cervical cancer, the correct risk factors mostly indicated by the nurses were early age at first sexual intercourse (56%), smoking (76%), multiple sexual partners (71.2%). As for screening methods, it was believed that BSE was a beneficial method to identify the early breast changes (84.8%) and MMG was able to detect the cancer without a palpable mass (57.6%). Little was known about the fact that women should begin cervical cancer screening approximately 3 years after the onset of sexual intercourse (23.2%) and if repeated pap smear test were normal, it could be done every 2–3 years. Most of the nurses considered that MMG decreases the mortality in breast cancer (65.6%) and also believed that pap smear test decreases the mortality in cervical cancer (75.2%). Despite high level of knowledge of breast cancer risk factors, symptoms and screening methods, inadequate knowledge of cervical cancer screening method were found among nurses.     

565名大学生儿童期性虐待经历回顾性调查

目的 了解大学生中儿童期性虐待发生情况,探讨性虐待经历对大学生心理健康的影响。方法 用自填式问卷,于2003年9月对一所普通高校565名大学生就有关儿童期受性虐待经历进行不记名回顾性调查。结果 在被调查的565名大学生中,有20.0％(32/160)的女生和14.3％(58/405)的男生报告16岁以前曾经历过非身体接触或身体接触的性虐待,其中18名(11.3％)女生和31名(7.7％)男生经历过身体接触的性虐待。儿童期性虐待经历首次发生年龄59.4％的女生、51.7％的男生发生在11岁及以下。与没有儿童期性虐待经历的学生比较,有儿童期性虐待经历的学生抑郁情绪量表得分高;健康状况自我感觉评价得分低;症状自评简表中的躯体症状、敌意、强迫症状和焦虑得分高;有过性交行为及在调查的近一年里考虑过自杀、饮酒醉过的比例高。结论 儿童性虐待问题在中国并非少见。大学生心理健康问题与儿童期性虐待经历相关。亟待开展儿童期性虐待的预防工作及为受害者提供心理健康服务。     

Health risks for older US adolescents in foster care: the significance of important others' health behaviours on youths' health and health behaviours

Background   Little research to date has examined older foster care youths' physical health and the associated health behaviours of the youth and important people in their lives (parents, peers and important non-parental adults).
Methods   Older US foster care youth ( n = 188) completed surveys on multiple indicators of self-report physical health, including number of chronic health problems, overall health and sick symptoms, as well as their own health-compromising behaviours and the health-compromising behaviours of important others.
Results   The findings suggested that boys, particularly those placed in non-kin foster homes and group homes, appeared to have poorer health than did boys in these placement settings. Girls, however, engaged in similar levels of health-compromising behaviours as boys. Furthermore, the health-compromising behaviours of peers and important non-parental adults (VIPs), but not parents, were associated with youths' health behaviours, which, in turn, were associated with the physical health status of the foster care youth.
Conclusion   Youth report high levels of health-related problems and involvement in health-compromising behaviours. Healthcare practitioners can help to improve the health and well-being of children in foster care by becoming informed about adolescent health behaviours, as well as the health behaviours of their peers and other important non-parental adults.     

A systematic review of factors affecting vaccine uptake in young children

BackgroundMany parents make a conscious decision not to vaccinate their child. Multiple beliefs and perceptions surround this choice. If uptake of routine child vaccination is to increase, public health communications about vaccines must be informed by evidence on the factors affecting uptake.MethodWe conducted a systematic review to investigate psychological, social and contextual factors associated with uptake of routine vaccines in young children. Studies were included if they reported analyses of the association between psychological factors and uptake or included parents’ self-reported reasons for or against vaccination.ResultsOur search identified 9110 citations after deduplication. Sixty-eight citations describing sixty-four studies were included in the review. The quality of the studies was mixed. There is strong evidence for an association between vaccination uptake and: not perceiving vaccines to cause adverse effects; general positive attitudes towards vaccination; positive vaccine recommendations; and perceiving fewer practical difficulties of vaccination. While there was good evidence for an association between vaccination and perceived susceptibility to the illness, evidence for an association between perceived severity of an illness and vaccination was weak. Other factors associated with vaccination include knowledge about the vaccine, social influences and trust in the healthcare profession. Having increased information about the vaccine was associated with vaccination, but the influence of different sources of information needs more research.ConclusionUnderstanding which factors are consistently associated with the decision to vaccinate one’s child is important to identify messages which should be targeted by public health communications about routine child vaccinations.     

Effects of neuromedin-β on caloric compensation, eating behaviours and habitual food intake

We have previously shown that a missense mutation (p.P73T) located in the neuromedin-β gene, a satiety peptide, was associated with higher levels of disinhibition, susceptibility to hunger, and body weight gain over time. In this study we compare caloric compensation, eating behaviour traits, food intake and adiposity between premenopausal women with (T73T) and without (P73P) mutation. Subjects (N = 153) were screened to find homozygous women (T73T) that were matched for age, BMI and use of oral contraceptives with 7 women (P73P) not carrying the mutation. Eating behaviour traits were assessed with the Three-Factors Eating Questionnaire and habitual dietary intakes with a 3-day dietary record. A randomized single-blind cross-over design was used to test the effect of p.P73T on caloric compensation. We measured appetite sensations and ad libitum dietary intake following two different energy preloads. We found no difference in eating behaviour traits, adiposity, appetite sensations, ad libitum dietary intake and caloric compensation. However, T73T women had lower habitual energy and carbohydrate intakes than P73P. Differences in carbohydrate intakes disappeared when expressed in percentage of energy. These results suggest that the neuromedin-β p.P73T mutation modulates energy intake without effects on macronutrient. A lack of power resulting from our difficulty to recruit enough T73T women precludes any definitive conclusion regarding the impact of this mutation on caloric compensation.     

Are There Differences in the Impact of Partner Violence on Reproductive Health Between Postpartum Women and Women Who Had an Elective Abortion?

The aim of this study was to determine if the effects of intimate partner violence (IPV) in the previous 12 months (current IPV) on newborn’s health, pregnancy outcomes and couple’s reproductive behaviours were different for postpartum (PP) women as compared to women who had undergone an elective abortion (EA) in Trieste (Italy). This study is part of an unmatched case–control study. The major findings are that current IPV was positively associated with previous stillbirth among both groups of women, but the association was only marginally significant. Among EA women only, current IPV was significantly associated with previous miscarriages (adjusted odds ratio, 2.41; 95 %CI, 1.13–5.14). In both groups of women, current IPV was associated with a lack of joint couple decision making about contraception; however, the magnitude of this effect was higher among PP women. This study reveals that IPV was associated with poor obstetrical history among both groups of women. But the associations of current IPV with previous EA and couple reproductive behaviours were stronger among PP women.     

Characteristics of maternal directiveness and responsiveness with young children with visual impairments

The purpose of this study was to investigate the relation between maternal responsive and directive behaviours and the development of young children with visual impairments. The participants were 17 mother-child dyads, and the children's ages ranged from 20 to 36 months of age. The amount, quality, and appropriateness of four maternal behaviours were rated during a free play session between mother and child and compared with a developmental outcome measure designed for young children with visual impairments. In general, the results showed that the quality of maternal control and appropriateness of directiveness were positively related to children's language development; whereas, the amount of these same behaviours was negatively related to language development. The findings also indicated that both the quality and amount of maternal goal-setting behaviours, and the quality of responsiveness were positively related to children's language skills, exploration of the environment and sensorimotor development. The findings are discussed in terms of maternal influence on child development.     

Community participation and citizenship in British health care planning: narratives of power and involvement in the changing welfare state

This article considers changing conceptions of local citizenship with particular reference to the idea of 'community participation' in the planning of state health care within Britain. The aim is to gauge the extent to which a political rhetoric of community participation in the 1990s constituted an attempt to redefine the relationship between health authorities (responsible for planning and prioritising services) and local communities. Data from aninvestigation encompassing 75 interviews is used to chart the manner in which health authority managers have re-articulated and given substance to the rhetoric of participation. The analysis appears to confirm a 'democratic deficit' with regard to decision-making in health care planning but there is a significant qualification. A process of 'professionalisation' and the growth of 'active management' (rather than 'active citizenship') may in part be off-setting the democratic deficit. This process is however highly contingent upon developments in health service policy and organisation.     

STD患者传染源、心理状况和就医行为研究

目的：探讨门诊STD（性传播疾病）患者传染源、心理状况和就医行为的特征。方法：对泸州地区4家医院性病门诊的1358名患者进行问卷调查和深入访谈。结果：77．4％的男性STD患者通过商业性伴染上性病，71．8％的已婚女性把感染源归咎于其丈夫，病后出现惊恐的男性占40．4％，女性占50．0％，因为病情所迫才求医的男性占84．1％、女性占60．0％，87．5％的患者最终就诊地点在皮肤性病科，分别有57．1％、76．5％、42．0％、7．0％的男性性病患者和92．0％、70．0％、54．2％、17．9％的女性患者表示会鼓励其配偶、同居者、临时性伴、商业性伴去医院诊治。结论：对性病患者应加强咨询和性健康教育，教育他们要慎重选择性伴、减少性伴数，鼓励他们提高防病意识，接受健康的生活方式。