SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A rabbi/chaplain listens to a 21st century woman tell about some complexities encountered in the blended family dynamics. He reminds her that such stressful phenomena are not as new as many believe, illustrating his point by interpreting the biblical account of Sarah and Hagar, noting particularly that some of the same decisions and actions taken in ancient times may still provide authentic insights to current family dynamics today.
Explore the source record for details and available documents.
BACKGROUND: The effects of traumatic brain injury on family dynamics and finances have not been extensively studied. We designed a 30-item survey to determine the effects of the injury on the child, parent(s), and siblings, and whether parents were retrospectively content with the decisions related to aggressiveness of care. METHODS: A questionnaire written on a sixth-grade reading level was mailed to 46 families of children who survived a traumatic brain injury resulting in an initial Glasgow Coma Scale score < or = 7. This is a descriptive study without statistical analysis. Human Studies Committee review and informed consent were obtained. RESULTS: Thirty-two of 46 (69.6%) surveys were completed by mail or telephone. Mean patient age at time of injury was 8.7 years, mean time since injury was 3 years, and mean Glasgow Coma Scale score was 3.7. Approximately one third of children have disabilities related to education, socialization, and/or self-care skills; require multiple health care visits each month; and require prescription medications. Over one third of families were impacted in a moderate to profoundly negative way; 30% of families reported a deterioration in finances or loss of job; and 16% reported a worsening of adult relationships. In 13 of 32 cases, modification of current housing or new housing was required to facilitate home care. Siblings were adversely affected in approximately 16 of 28 families, exhibiting behavioral problems, increased fear, and withdrawal from the injured child. Only 1 of 32 families stated that they would have considered less aggressive treatment, even if it led to the child's death. CONCLUSION: Traumatic brain injury of a child had a negative impact on family dynamics and/or sibling behavior in more than one third of families. Despite this, most families would not limit or withdraw care if they could reconsider decisions regarding treatment. This information can be used to counsel families.
Corporal punishment is widely practiced despite evidence of its harm to children. Clinicians can more effectively counsel alternatives if they: are clear in their own minds about the risks of corporal punishment and its boundaries with reportable child maltreatment; appreciate parents' justifications for corporal punishment and offer corresponding alternatives; demonstrate their interest and expertise in matters of child behavior and family dynamics; practice communication techniques that elicit discussion of psychosocial topics and facilitate mutual problem solving; let parents take the lead in tailoring alternative disciplinary strategies to the family's unique needs; start early helping parents understand child behavior in general and their child's temperament and development in particular. Clinicians as a group should demonstrate a united stand against the use of violence within families. Both undergraduate and continuing medical education should involve training in communication skills in general and problem-solving techniques in particular. Pediatricians need more time during their training to learn about child behavior and family dynamics.
We describe the identification, biochemical characterisation, and mutation of a novel mouse gene: Sp5. Sp5 encodes a protein having a C-terminal C(2)H(2) zinc finger domain closely related to that of the transcription factor Sp1. In vitro, DNA binding studies show that it binds to the GC box, a DNA motif present in the promoter of a very large number of genes, including Brachyury, and recognised by members of the Sp1 family. However, outside of its DNA binding domain, Sp5 has little homology with any other member of the Sp1 family. In contrast to the ubiquitous expression of Sp1, Sp5 exhibits a remarkably dynamic pattern of expression throughout early development. This is suggestive of a role in numerous tissue patterning events, including gastrulation and axial elongation; differentiation and patterning of the neural tube, pharyngeal region, and somites; and formation of skeletal muscle in the body and limbs. Mice homozygous for a targeted mutation in Sp5 show no overt phenotype. However, the enhancement of the T/+ phenotype in compound mutant mice (Sp5(lacZ)/Sp5(lacZ), T/+) indicates a genetic interaction between Sp5 and Brachyury. These observations are consistent with a role for Sp5 in the coordination of changes in transcription required to generate pattern in the developing embryo.
Explore the source record for details and available documents.
This article is the continuation of a previous investigation about educational necessities in perinatal health of pregnant adolescent mothers. Now we present the design and evaluation of an Educational Course for that group. The theoretical mark of the Course corresponds to the education of adults, under the focus of the grupal learning. The content included gineco obstetrics topics, prevention of perinatal risks and the analysis of the social and cultural enviroment. As evaluation instrument, a self-applicable questionnaire of thirteen open questions was built on four aspects: family dynamics, utility of the course, utility of the information and behavior of the pregnant adolescents. A sample of 101 mothers of pregnant adolescents participated of the study from January 1999 to May 2000. The results indicate that the family dynamics was modified favorably in 88% of the cases soon after the attendance of mothers like adolescents to their respective courses, although some factors related with the father show a lack of commitment about the family situation. The 100% of the mothers considered important the attendance to the course because it is an educational instrument, so much for pregnant daughters as for themselves. The Course propitiated the exchange of preventive information between them in 87% of the cases. 97% of the mothers informed changes in their daughter's attitudes soon after her attendance to the course.
OBJECTIVE: Three areas of basic family research were selected for review as being of special importance to the clinically oriented child and adolescent psychiatrist: behavioral genetics, expressed emotion, and the interaction of family dynamics and childhood illness. METHOD: Medline and PSYCINFO searches using appropriate keywords were obtained for each of the 3 major areas. All English-language articles published after 1989 that included empirical research pertaining to children or adolescents were reviewed. RESULTS: Behavioral genetics research indicates that the shared environment, including issues of parental monitoring and discipline, is important in the development and outcome of externalizing disorders. Differential parental treatments of one sibling are critical in internalizing disorders. Criticism (as measured by expressed emotion) is associated with poor outcome of many childhood medical and psychiatric disorders. Chronic illness in a child changes the family dynamics toward being more structured and less emotionally warm and communicative. The family's role in adherence to treatment is critical, and families with high levels of criticism have more difficulty. CONCLUSIONS: Families can cause problems, but many times the problems families have are in response to a child's problems. There is a continued need to empirically assess which family processes are important for specific childhood disorders.
The purpose of this study was to examine associations between bulimia nervosa and family meals. Female college students ( N = 560) completed surveys assessing eating disorder pathology, family meal frequency, and family environment. Results indicate that dinner was the meal most frequently shared with family members. The frequency of eating dinner together as a family was inversely associated with scores on two measures of bulimia, and these associations remained statistically significant after controlling for other familial factors. Familial variables associated with bulimic symptoms included low cohesion and independence, and high achievement orientation. While results indicate that bulimic behaviors are inversely associated with the frequency of a family dinner, these relationships need to be explored within the context of broader family dynamics. Individuals working in primary and secondary prevention settings should evaluate family meal patterns and dynamics in families with a member with an eating disorder.
This article is intended to familiarize the ambulatory care provider with possible uses of children's drawings as assessment tools. Drawings can be a useful adjunct in detecting perceptual-motor difficulties and developmental delay, and can provide clues to self-image and family dynamics. Piaget's theory of cognitive development provides a framework to evaluate the child's intellectual development as reflected in drawings. The developmental scales of Koppitz are presented as a practical screening tool. The Koppitz scales include both developmental norms and items that might indicate emotional problems. Observing the child's drawing of the family provides clues to family dynamics. Becoming highly skilled in the evaluation of children's drawings requires a familiarity with neurophysiology, education, psychology, and psychoanalytic and developmental theory, along with intuition and practice. This article presents an introduction to evaluating children's drawings.
Our purpose in conducting this study was to explore relationships among family dynamics, parent-fetal attachment, and infant temperament in 230 mother-father pairs from the third trimester of pregnancy to when their infant was 7 to 9 months old. Mothers reported increased role conflict during this time, as well as more role conflict than their partners. First-time parents (n = 133) perceived more positive family dynamics than second-time parents (n = 97), as well as greater parent-fetal attachment. Maternal-fetal attachment was greater than paternal-fetal attachment. Health care providers can provide support for new parents as they negotiate new role relationships.
A study is reported of the bifurcation of the branching of a cycle (Poincare-Andronov-Hopf bifurcation) from a smooth one-dimensional submanifold of equilibria of a dynamical system that depends on a vector parameter and admits cosymmetry. The paper reports a topological classification of local phase portraits near a known equilibrium, when the system parameter is close to its critical value that corresponds to an oscillatory instability. New phenomena that are not observed in the classical case of an isolated equilibrium include a delay of cycle creation with respect to the system parameter, loss of stability by the family of equilibria without loss of attraction, and the possibility of unstable supercritical self-oscillations. (c) 1997 American Institute of Physics.
School-aged boys with hemophilia, their parents, and siblings were interviewed and observed over a 5-year period, the field work taking place in their homes, schools, and during hospitalization, clinic visits, and summer camp periods. Sequential, open-ended interviews, and participant-observation techniques enabled the inquiry to study the process of the children's development as a major factor in changes that occurred in the management of their illness over time. Qualitative issues identified for study focused on the divisions of labor inherent in family interactions concerning the care of their hemophiliac children. The locus of control relative to particular technical medical interventions shifted from the medical center to a parent, eventually to each boy, with his associated development. Shifts were not entirely unidirectional, particular conditions influencing the tasks which transfer, the pace of changes and the resulting consequences. Categories of tasks are examined, with specific focus being the learning-teaching processes, the related awareness contexts, and the temporal dimensions involved. Concurrent with the hemophiliac boys' learning to infuse themselves with their particular missing clotting factor, a speaking up for themselves in interaction with peers and nonparent adults, relative to defining or treating the hemophilia, did not shift away from their parents. The boys' nonassumption of this aspect of their interactions is associated with a developing self-consciousness about their 'differences', which indicated a greater willingness to take physical risk (nonattention to the hemophilia requirements) than the social risk of emphasizing difference from peers. Adult intermediating, especially in the larger school contexts, thus remained primarily the parents' task in order to support the children's integration into the organizations.(ABSTRACT TRUNCATED AT 250 WORDS)
Many of the challenges facing children now are a function of changing times, including increase in urbanization, political violence, changing family forms, and in some areas decreased supplies of adequate food. This review focuses particularly on those changes in which children are the victims and which induce new threats for them, rather than on problems such as child disability or mental illness. The outcome variables of interest in this paper are dimensions of children's psychosocial development, including cognitive development, psychological adjustment and aggression, whereas the companion paper in this issue (Caldwell P., Child survival: vulnerability and resilience in adversity in the European past and the contemporary Third World, Soc. Sci. Med.) [1] focuses on physical aspects of children's development. The risks that are hurdles in the process of development of a young child begin from conception and carry on into later life. To address them all would be impossible; thus, in order to do justice to the issues at hand, we have chosen those risks that, in our view, are important in a child's psychosocial development in developing countries. This paper will thus provide a discussion of the concepts of risk and resilience, then apply these concepts to the analysis of three examples of risk faced by children today: nutritional threats (e.g. malnutrition due to decline in breastfeeding); family dynamics and types of family forms (e.g. child fostering and non-traditional families); and experiences of violence (domestic or political). In each case, the same four questions will be addressed: what are the consequences of the risk factor for children, what are the etiologies and conditions of risk, are there any children who seem to cope with the risk factor successfully and what are some of the protective factors, and what interventions or programs would help support these children?
Genetic counseling is important in any genetic testing situation in order to address the various issues related to obtaining a genetic diagnosis. Presymptomatic testing for adult-onset neurodegenerative disease, in particular, presents a complex counseling scenario. It is imperative to discuss the potential impact of test results on patients' family dynamics, insurability and employability, family planning, and future health in addition to ascertaining a complete understanding of recurrence, inheritance, and testing parameters. The Huntington disease presymptomatic testing protocol is well-defined and has been used for more than 10 years. These guidelines, which protect both patient and provider, can now be applied to other diseases as further presymptomatic testing capabilities are realized.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A survey was conducted in a population of about 8000 Greek high school students (grades 9 and 12) in order to investigate factors possibly contributing to alcohol consumption. A self-rating multiple choice questionnaire was used. The present report focuses on students with alcoholic parents. Parameters studied include students' alcohol and drug use, school performance, family relationships, socioeconomic factors and parental control. In 3.3% of the sample parental alcoholism was reported. The results indicated that parental alcoholism is a strong predictor variable for the student's alcohol and drug use. Furthermore, predictability of the student's alcohol and drug use is increased when relatives' and friends' alcoholism are taken into account. Thus, family and/or peer actual alcohol use patterns appear to be a strong influence on adolescent alcohol and drug use. School performance is worse in children of alcoholics, and family situations (eg. divorces) as well as family dynamics (relationships with the family) are disturbed, in comparison with families of students with nonalcoholic parents. These results are discussed in terms of 'modelling' for drinking and drug behaviour and the socialisation process within the family.