The association of early IQ and education with mortality: 65 year longitudinal study in Malmö, Sweden

Objectives To establish whether differences in early IQ explain why people with longer education live longer, or whether differences in father’s or own educational attainment explain why people with higher early IQ live longer

Association between labour market trends and trends in young people's mental health in ten European countries 1983-2005

<p>Abstract</p> <p>Background</p> <p>Mental health problems have become more common among young people over the last twenty years, especially in certain countries. The reasons for this have remained unclear. The hypothesis tested in this study is that national trends in young people's mental health are associated with national trends in young people's labour market.</p> <p>Methods</p> <p>National secular changes in the proportion of young people with mental health problems and national secular labour market changes were studied from 1983 to 2005 in Austria, Belgium, Denmark, Finland, Hungary, Norway, Spain, Sweden, Switzerland and the United Kingdom.</p> <p>Results</p> <p>The correlation between the national secular changes in the proportion of young people not in the labour force and the national secular changes in proportion of young people with mental health symptoms was 0.77 for boys and 0.92 for girls.</p> <p>Conclusion</p> <p>Labour market trends may have contributed to the deteriorating trend in mental health among young people. A true relationship, should other studies confirm it, would be an important aspect to take into account when forming labour market policies or policies concerning the delivery of higher education.</p

Maternal educational level, parental preventive behavior, risk behavior, social support and medical care consumption in 8-month-old children in Malmö, Sweden

<p>Abstract</p> <p>Background</p> <p>The social environment in which children grow up is closely associated with their health. The aim of this study was to investigate the relationship between maternal educational level, parental preventive behavior, parental risk behavior, social support, and use of medical care in small children in Malmö, Sweden. We also wanted to investigate whether potential differences in child medical care consumption could be explained by differences in parental behavior and social support.</p> <p>Methods</p> <p>This study was population-based and cross-sectional. The study population was 8 month-old children in Malmö, visiting the Child Health Care centers during 2003-2007 for their 8-months check-up, and whose parents answered a self-administered questionnaire (n = 9,289 children).</p> <p>Results</p> <p>Exclusive breast feeding ≥4 months was more common among mothers with higher educational level. Smoking during pregnancy was five times more common among less-educated mothers. Presence of secondhand tobacco smoke during the first four weeks of life was also much more common among children with less-educated mothers. Less-educated mothers more often experienced low emotional support and low practical support than mothers with higher levels of education (>12 years of education). Increased exposure to unfavorable parental behavioral factors (maternal smoking during pregnancy, secondhand tobacco smoke and exclusive breastfeeding <4 months) was associated with increased odds of in-hospital care and having sought care from a doctor during the last 8 months. The odds were doubled when exposed to all three risk factors. Furthermore, children of less-educated mothers had increased odds of in-hospital care (OR = 1.34 (95% CI: 1.08, 1.66)) and having sought care from a doctor during the last 8 months (OR = 1.28 (95% CI: 1.09, 1.50)), which were reduced and turned statistically non-significant after adjustment for unfavorable parental behavioral factors.</p> <p>Conclusion</p> <p>Children of less-educated mothers were exposed to more health risks, fewer health-promoting factors, worse social support, and had higher medical care consumption than children with higher educated mothers. After adjustment for parental behavioral factors the excess odds of doctor's visits and in-hospital care among children with less-educated mothers were reduced. Improving children's health calls for policies targeting parents' health-related behaviors and social support.</p

What causes increasing and unnecessary use of radiological investigations? a survey of radiologists' perceptions

<p>Abstract</p> <p>Background</p> <p>Growth in use and overuse of diagnostic imaging significantly impacts the quality and costs of health care services. What are the modifiable factors for increasing and unnecessary use of radiological services? Various factors have been indentified, but little is known about their relative impact. Radiologists hold key positions for providing such knowledge. Therefore the purpose of this study was to obtain radiologists' perspective on the causes of increasing and unnecessary use of radiological investigations.</p> <p>Methods</p> <p>In a mailed questionnaire radiologist members of the Norwegian Medical Association were asked to rate potential causes of increased investigation volume (fifteen items) and unnecessary investigations (six items), using five-point-scales. Responses were analysed by using summary statistics and Factor Analysis. Associations between variables were determined using Students' t-test, Spearman rank correlation and Chi-Square tests.</p> <p>Results</p> <p>The response rate was 70% (374/537). The highest rated causes of increasing use of radiological investigations were: a) new radiological technology, b) peoples' demands, c) clinicians' intolerance for uncertainty, d) expanded clinical indications, and e) availability. 'Over-investigation' and 'insufficient referral information' were reported the most frequent causes of unnecessary investigations. Correlations between causes of increasing and unnecessary radiology use were identified.</p> <p>Conclusion</p> <p>In order to manage the growth in radiological imaging and curtail inappropriate investigations, the study findings point to measures that influence the supply and demand of services, specifically to support the decision-making process of physicians.</p

School Choice and Vocational Guidance for Schoolchildren with Chronic Diseases and Other Health Problems

Osim praćenja rasta, razvoja i zdravstvenog stanja učenika tijekom školovanja, liječnik školske medicine razmišlja i o njihovu profesionalnom razvoju. Posebnu pozornost zahtijevaju učenici s kroničnim bolestima, kojih je prema istraživanjima 10 % do 15 %. Prije izbora zanimanja potrebno je upoznati roditelje i učenike s ograničenjima koja proizlaze iz prirode bolesti ili stanja. To omogućuje učenicima da razviju interes za zanimanja za koja nemaju kontraindikaciju. Sistematski pregled u osmom razredu osnovne škole procjena je učenikovih psihofi zičkih sposobnosti za nastavak srednjoškolskog obrazovanja. Tijekom pregleda provodi se profesionalno informiranje za sve učenike. Učenici s kroničnim bolestima, teškoćama u razvoju i drugim poremećajima zdravlja upućuju se na profesionalno usmjeravanje. Cilj ovog rada bio je prikaz razloga upućivanja na školsko i profesionalno usmjeravanje učenika osmih razreda, deset osnovnih škola iz Varaždinske županije, u razdoblju od školske godine 1998./99. do 2007./08. Od ukupno 4939 pregledanih učenika, na profesionalno usmjeravanje bilo je upućeno njih 458 (9,3 %). Najčešći razlozi upućivanja bili su bolesti i stanja iz skupine duševnih poremećaja i poremećaja ponašanja, sa zastupljenošću od 41,3 %. Preporuke stručnog tima za profesionalno usmjeravanje za daljnje školovanje nije slijedilo 10,5 % učenika. Za učenike s kroničnim bolestima i drugim poremećajima zdravlja bilo bi potrebno osigurati dovoljan broj upisnih mjesta u srednjim školama te kontinuirano pratiti njihov profesionalni razvoj radi intervencije u slučaju potrebe promjene škole i uvida u ishod obrazovanja. To bi se postiglo koordiniranim radom školskih liječnika, timova za profesionalno usmjeravanje, srednjih škola i županijskih upravnih odjela za prosvjetu, kulturu i šport.By following a child’s growth, development, and health, school medicine specialist can see opportunities for career choice. Special attention is needed for schoolchildren with chronic diseases and developmental difficulties, because of limited occupation choices. Studies report 10 % to 15 % prevalence of chronic diseases among schoolchildren. Parents and children should be informed about child’s limitations before career choice. It would be helpful for the students to develop interests for occupations that are not contraindicated for their condition. Physical examination gives an insight into the psycho-physical abilities of an eighth-grade primary school student for further education. During examination, counselling and vocational guidance is provided for all students with chronic diseases and other health problems. All procedures are oriented to personal abilities and preferences. The aim of this study was to analyse the reasons for vocational guidance in the Varaždin County of Croatia. It included eighth-grade students from ten primary schools from 1998/99 to 2007/08. Of 4939 students, 458 (9.3 %) with chronic diseases and health difficulties were referred to vocational guidance. Of these, 41.3 % were referred due to mental and behavioural disorders. These students were assessed and received a recommendation for at least two occupations. Forty-eight students (10.5 %) did not follow the recommendation. In a coordinated effort, school physicians, vocational guidance experts, and school and local authorities should secure enrollment of students with chronic diseases and health difficulties in secondary schools and follow their development and education to provide them the best available career opportunities

Minimising treatment-associated risks in systemic cancer therapy

Aim of the review To review the consequences of drug-related problems (DRP) in systemic cancer therapy and identify specific contributions of the pharmacist to minimise treatment-associated risks. Method Searches in PubMed, Embase and the Cochrane Library were conducted. Bibliographies of retrieved articles were examined for additional references. Only papers in English between 1980 and 2007 were included. Results In systemic cancer therapy there is an enormous potential for DRP due to the high toxicity and the complexity of most therapeutic regimens. The most frequently reported DRP can be classified into adverse effects, drug–drug interactions, medication errors, and non-adherence. Pharmacists have enhanced efforts to assure quality and safety in systemic cancer therapy together with other health care providers. In consequence, oncology pharmacy has evolved as a novel specialist discipline. The endeavour to merge and co-ordinate individual activities and services of the pharmacist has led to pharmaceutical care concepts which aim at offering novel solutions to the various DRP. Conclusion Pharmaceutical care for cancer patients should be developed within research projects and integrated into disease management programs in order to ensure broad implementation

Mechanism and Enantioselectivity in Palladium-Catalyzed Conjugate Addition of Arylboronic Acids to β‑Substituted Cyclic Enones: Insights from Computation and Experiment

Enantioselective conjugate additions of arylboronic acids to β-substituted cyclic enones have been previously reported from our laboratories. Air- and moisture-tolerant conditions were achieved with a catalyst derived in situ from palladium(II) trifluoroacetate and the chiral ligand (S)-t-BuPyOx. We now report a combined experimental and computational investigation on the mechanism, the nature of the active catalyst, the origins of the enantioselectivity, and the stereoelectronic effects of the ligand and the substrates of this transformation. Enantioselectivity is controlled primarily by steric repulsions between the t-Bu group of the chiral ligand and the α-methylene hydrogens of the enone substrate in the enantiodetermining carbopalladation step. Computations indicate that the reaction occurs via formation of a cationic arylpalladium(II) species, and subsequent carbopalladation of the enone olefin forms the key carbon–carbon bond. Studies of nonlinear effects and stoichiometric and catalytic reactions of isolated (PyOx)Pd(Ph)I complexes show that a monomeric arylpalladium–ligand complex is the active species in the selectivity-determining step. The addition of water and ammonium hexafluorophosphate synergistically increases the rate of the reaction, corroborating the hypothesis that a cationic palladium species is involved in the reaction pathway. These additives also allow the reaction to be performed at 40 °C and facilitate an expanded substrate scope