Cultural transitions and epidemiology.

The analysis of cultural patterns, as an observational and qualitative tool in epidemiological research, is advanced. This approach to epidemiology, biomedicine, human and cultural ecology, focuses on the following theoretical points of view: (i) the intrinsic non-linearity of natural dynamics, (ii) the role of fluctuations in the evolution of self-organized systems, (iii) the reformulation of the homeostasis concept, through the hypothesis of the co-existence of different levels of boundaries of stability (the non-linear processes of adaptation) and the dynamics of transitions (the physiological jumps) between them, (iv) the image of the psychobiological status in peripheral cells (i.e. blood lymphocytes) due to the morphofunctional unity of neuroendocrine and immune systems, (v) the significance of emic/ethic operations used in cultural anthropology. In this conceptual framework, transitions among migrants or within populations, following sudden changes in cultural patterns, are particular events that can also be very interesting for epidemiological research; they can leave the marks of underlying intertwined psychobehavioral, metabolic and immune physiology; they can also be informative as regards the modulation of autonomy, disability, morbidity and mortality curves.

Psycho-biological adaptive dynamics in aging populations.

The dynamics of self-organized systems are characterized by irreversible processes in which the exchange of matter, energy and signals among genetic, metabolic and environmental patterns are nonlinear; reversible events (i.e., at equilibrium) occur only in special cases. The adaptations of complex systems to the environment, at all levels of structural organization, involve boundaries of stability and dynamics of transition among stabilities; in this view, the classical concept of homeostasis refers only to the observed meta-stable status, reached, generally described by means and standard deviations, with the exclusion of three basic aspects of natural processes: (i) the prior evolutive dynamics, (ii) the coexistence of other meta-stable statuses and (iii) the role of the fluctuation as regards the successive evolution of the system. Some qualitative models to approach research on aging are discussed on the basis of nonlinear system theory.

Self-perception of health and survival. A 10-year follow-up among Italians aged over sixty.

The aim of this study was to evaluate the long-term relationship between the self-perception of health and survival data in an Italian population. The study was a cross-sectional survey performed in 1978-1982; survival data were obtained from the municipal administration register 10 years later. Subjects were selected in the city of Genoa (NW of Italy) through a preventive bio-medical survey. Baseline data involved 433 Italian subjects 60+ years old (34.4% males, age range 60-92), living at home, with adequate/ good physical and psychological autonomy. Self-perception of health and symptomatology were recorded using standardized items. Self-perception of health, scored from 0 (healthy) to 4 (very sick), was closely related to the survival status (UML-LOGIST: beta = 0.72 +/- 0.25, aOR (exp beta) = 2.06, CI(95%) = 1.27-3.30, chi 2 = 8.70, p = 0.0032), controlling for the effect of age, gender, years of schooling, income, doctor's appraisal. Symptomatology was evaluated through 30 close items; muscular strength and motility (beta = 0.51 +/- 0.31, p = 0.1), psychic troubles (beta = 0.47 +/- 0.24, p = 0.05), articular pain and rachialgias (beta = -0.62 +/- 0.25, p = 0.01), neuralgia (beta = -0.76 +/- 0.37, p = 0.04), and dyspeptic disorders (beta = -0.74 +/- 0.32, p = 0.02), were the symptomatologic conditions linked to survival levels. These findings confirm the importance of the self-perception of health as a predictor of survival status also in an Italian sample. To explain the predictive covariance of the baseline self-perception of health versus mortality, the decreased variability in the adaptive processes during the transition from psychophysiological to physiopathological states was hypothesized.