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PubMed1997

The neighborhood history calendar: a data collection method designed for dynamic multilevel modeling.

"This paper presents a new data collection method, called the Neighborhood History Calendar, designed to collect event histories of community-level changes over time. We discuss the need for and the uses of this method. We describe issues related to the design of instruments, collection of data, and data entry. We provide detailed examples from an application of this method to the study of marriage, contraception, and fertility in rural Nepal. The paper addresses applications of this same technique to other settings and research problems. We also extend the technique to collection of other forms of contextual-history data, including school histories and health service histories. Finally, we discuss how Geographic Information System (GIS) technology can be used to link together multiple sources of contextual-history data."

Asia↗
PubMed1983

Inbreeding studies in Brasilian schoolchildren.

We present results of comparisons between consanguineous and control couples and their children in Southern Brasil. Multiple regression, t-test and chi 2 analyses were applied to the data. The following variables were investigated; Parents: structure of first cousin marriages, latitude and longitude of birthplaces, cohabitation time, rurality, marriage age, occupation, number of liveborn children, and frequency of twinning. Schoolchildren: clinical data as classified into 24 discontinuous traits, each one subdivided into two categories (number and severity), and seven continuous traits (weight, height, pulse rate, respiratory rate, systolic pressure, diastolic pressure, and temperature); nutrition indices and biotype; family names; intelligence tests and school performance; birth order, age, hair color, hair type, eye color, and skin color; twinning in the sibship, and infant mortality among sibs of the propositi. Our study showed a) nonrandomness of consanguineous marriages as detected on structural, racial, geographical, and temporal levels; b) a heavy mutational load of about 1.5 lethons acting on infant mortality; c) no inbreeding effect on morbidity in general (with a possible exception of "ear morbidity", including hearing deficit); d) a modest inbreeding depression on height (a decrease of 2 cm with an increase of 10% of inbreeding); 3) a suggestion of inbreeding depression on "intelligence".

Brazil↗
PubMed1986

A set of double-angled needle holders and long, angled tissue forceps for use in surgery of the abdomen.

A set of double-angled needle holders and long, angled tissue forceps have been designed and presented for use in surgery of the abdomen. The problems of passage and control of curved needles in all directions is well recognized. The marriage of design and presentation addresses the mechanical and anatomic needs of surgeons in the pelvis, subdiaphragmatic area, and in large and obese patients. Multiple variables in use provided by these instruments, particularly when used together, enhance surgical control at problem sites.

Abdomen↗
PubMed2007

Prevalence of obesity, central obesity and the associated factors in urban population aged 20-70 years, in the north of Iran: a population-based study and regression approach.

Obesity is an undesirable outcome of changing of lifestyle and behaviours. It is also reversible predisposing factor for the development of several debilitating diseases. This study was aimed to determine the prevalence rate of obesity, overweight, central obesity and their associated factors in the north of Iran. We conducted a population-based cross-sectional study with a sample of 1800 women and 1800 men with respective mean ages of 37.5 +/- 13.0 and 38.5 +/- 14.2 years of urban population aged 20-70 years living in the north of Iran. The demographic and lifestyle data, in particular, age, gender, marital status, marriage age, family history of obesity, educational level, occupation, occupational and leisure time physical activity, duration of exercise per week, parity and the number of children were collected with a designed questionnaire. Diagnosis of obesity and central obesity were confirmed by the WHO standard recommended method by determining of body mass index (BMI) and waist circumference (WC). Logistic regression model was used to estimate the adjusted odds ratio (OR) and its 95% confidence interval. Over half of the study subjects were at educational levels of high school or higher; 79.4% of population was married and 35.3% had a family history of parental obesity. The majority of subjects in particular women had none or low levels of physical activity. The overall prevalence rates of obesity and overweight were 18.8% and 34.8% respectively. The overall prevalence rate of central obesity was 28.3%. The rate of obesity in women was higher than men (P < 0.0001). In both genders, particularly in the women, the rate of obesity was raised by increasing age. There was an inverse relation between the risk of obesity and marriage age, the high level of education (OR = 0.19, P < 0.0001), severe occupational activity (OR = 0.44, P < 0.0001), the level of exercise (in subjects with 3-4 h exercise per week, OR = 0.58, P < 0.001) and leisure time activity. Marriage, history of parental obesity and parity > or =5 were associated with increased risk of obesity (OR = 2.2, P < 0.001 and OR = 2.43, P < 0.0001 and OR = 3.73, P < 0.0001 respectively). The results of this study indicate an increased rate of obesity and overweigh in the north population of Iran. With respect to these findings, low level of activity and education, parity, family history of obesity, marriage at earlier age and ageing are responsible for both obesity and central obesity in the north of Iran. Therefore, a community-based multiple strategies are required to combat with increasing rate of obesity and its subsequent complications such as diabetes, coronary artery disease, hypertension and osteoarthritis.

Adult↗
PubMed2000

Marital trajectories and mental health.

This study expands the marital status and mental health literature by examining several dimensions of marital trajectories, including the number and type of prior marital losses and duration in current status. Data are drawn from the Piedmont Health Survey of the National Institute of Mental Health Epidemiologic Catchment Area Study, collected in 1982-83 (n = 2,158). Results indicate that number of prior losses moderates the health-enhancing effect of being currently married; higher order marriages are associated with worse mental health. Although results vary across the mental illnesses examined (depression, anxiety, and substance use), the negative effect of multiple loss also is observed for the currently divorced and widowed. There is less evidence that the type of prior loss (i.e., divorce or widowhood) moderates the effect of current marital status on mental health; however, some support is found among the presently widowed. The analyses of duration in current status suggest that the rate of decline in symptoms of anxiety following one's most recent loss varies by marital history among the currently widowed.

Adult↗
PubMed2004

Socioeconomic, demographic, and geographic variables affecting the diverse degrees of consanguineous marriages in Spain.

In a population the inbreeding coefficient alpha is determined by the relative incidence of the various degrees of consanguineous marriages--uncle-niece or aunt-nephew (C12), first cousin (C22), first cousin once removed (C23), second cousin (C33)--which may be related to temporal, geographic, demographic, and economic factors. Using published information from Spain corresponding to urban and rural areas, in this article we seek to establish how each specific relationship behaves with respect to geographic, demographic, and socioeconomic factors, to determine differential urban-rural patterns, and to study whether the diverse types of consanguineous matings relate homogeneously to these factors. For this purpose we performed multiple regressions in which the dependent variables were the different degrees of consanguinity previously selected and the independent variables were geographic, demographic, and economic factors. Our results indicate that the various types of consanguineous marriages in Spain are more conditioned by geographic, demographic, and economic variables than by the inbreeding level alpha (the coefficient of determination was between 0.22 and 0.72; the maximum for alpha was 0.35). A regional pattern exists in Spain and corresponds to close and to remote kinship, which may be mainly related to economic and family factors. Close relationships appear to be more associated with economic variables, whereas second-cousin marriages correspond largely to rural areas of the Spanish Central Plateau.

Catholicism↗
PubMed2005

Marital coitus across the life course.

It remains unclear whether the frequency of marital coitus does in fact decline universally across the life course, what shape that decay normally takes, and what best accounts for it: increasing marriage duration, women's age or age of their partners. Using cross-sectional Demographic and Health Survey (DHS) data of 91,744 non-abstaining women in their first marriage, a generalized linear model is used to determine if there is a consistent pattern in the life course pattern of degradation in the frequency of marital coitus. Datasets were drawn from nineteen countries in Asia, Africa and the Americas. Use of very large samples allows proper disentangling of the effects of women's age, husband's age and marital duration, and use of samples from multiple countries allows consideration of the influence of varied prevailing fertility regimes and fertility-related practices on life course trajectories. It is found that declining coital frequency over time seems a shared demographic feature of human populations, but whether marriage duration, wife's age or husband's age is most responsible for that decline varies by country. In many cases, coital frequency actually increases with women's age into their thirties, once husband's age and marriage duration are taken into account, but in most cases coital frequency declines with husband's age and marital duration.

Adult↗
PubMedDate not supplied

Natural fertility in northeastern Mexico.

BACKGROUND: The aims of this study were as follows: 1) to describe the fertility of a sample of Mexican women (> or =45 years of age, married, not using any family planning methods, and residing in the Mexican state of Nuevo León); 2) to determine whether or not the distribution of completed family size fits the negative binomial distribution, as in other populations studied in the world, and 3) to assess the association between fertility and 10 explanatory variables. METHODS: A sample of 410 women was interviewed at and selected from seven medical units of the Instituto Mexicano del Seguro Social (IMSS). The women were grouped by their year of birth (1896-1925 and 1926-1955) and birthplace [persons whose four grandparents were born in northeastern Mexico (NE) and outside northeastern Mexico (Not-NE)]. A binomial negative distribution analysis was assessed. Multiple linear regression was used to assess association between fertility (transformed by the use of inverse hyperbolic sines) and 10 explanatory variables, including age at marriage, heterozygosity, individual admixture, wife's education, husband's education, wife's occupation, husband's occupation, and couple's residence zone, birth year, and birthplace. RESULTS: Completed fertility was only associated with age at marriage. This population showed a fertility pattern similar to those described in Venezuelan and Brazilian populations in 1950 and 1940, respectively. CONCLUSIONS: We conclude that before worldwide family planning programs, fertility was determined mainly by natural selection forces.

Adolescent↗
PubMed2002

Cerebral lipidoses in patients with progressive neurodegeneration: a study from south India.

OBJECTIVE: To study the prevalence and clinical profile of cerebral lipidoses in patients with progressive neurodegeneration. SUBJECTS AND METHODS: A total of 771 patients clinically diagnosed with a progressive neurodegenerative disease were investigated for lipidoses. Specific enzyme assays in serum and leucocytes and other relevant investigations, including histopathology, neuroimaging and neurophysiological studies were conducted when indicated. RESULTS: Fifty-four cases of sphingolipidoses and 1 case of sialidosis type 1 were diagnosed. The sphingolipidoses consisted of 30 cases of metachromatic leukodystrophy, 13 cases of Tay-Sachs disease and its variants, 11 cases of Sandhoff disease, and 1 case each of Niemann-Pick disease and multiple sulphatase deficiency. The clinical features were similar to earlier reports. Parental consanguinity was present in 63.6% of patients. CONCLUSIONS: In south India, where consanguineous marriages are strongly favoured, inherited diseases such as the cerebral lipidoses should be considered when evaluating a patient with progressive neurodegeneration. The establishment of specialised referral centres would provide a helpful approach to the prevention and management of these fatal disorders.

Journal Article↗
PubMed2004

Personal Health Practices.

HEALTH ISSUE: There are differences in health practices and self-rated health among different socio-demographic groups of women. The relationship between socio-demographic status and a) a range of health behaviours and b) a combination of multiple risk and multiple health promoting practices were examined. The relationship between self-rated health and health practices was also assessed. KEY FINDINGS: There were geographic differences in health practices with women in British Columbia having the highest odds of engaging in multiple health promoting practices, while women in Quebec had the lowest. Reports of engaging in multiple risk behaviours were most common in Ontario. Women from Ontario had the highest odds of reporting very good/excellent health and women from British Columbia had among the lowest odds.The data supported a strong social gradient between an increase in income/education and healthy practices, especially those that are health promoting. However, women with higher education were more likely to be overweight and those with higher incomes were more likely to drink alcohol regularly.Immigrant women were less likely to engage in multiple health risk practices compared to Canadian-born women. However, they were less likely to report very good/ excellent health than non- immigrants. While marriage appeared to have a generally protective effect on women's health practices, single women were more likely to be physically active and have a normal weight. DATA GAPS AND RECOMMENDATIONS: More sensitive indicators need to be developed to better understand possible reasons for the socioeconomic gradient. Data collection should focus on both rural and Aboriginal populations.

Journal Article↗
PubMed1996

The difficult patient: creation of a curriculum by third-year family practice residents.

BACKGROUND AND OBJECTIVES: Family practice residents tend to perceive psychosocial problems as less important than other factual aspects of their curriculum. To address this, we developed a problem-based learning (PBL) approach to the biopsychosocial model of medical care. METHODS: Third-year residents presented current problematic patients at a PBL advanced psychiatry conference. Data were collected on topics generated, resident attendance, and conference evaluation. RESULTS: The residents generated a topic list that closely matched a prior faculty-generated list. Some topics were discussed on multiple occasions; others not on the faculty list were also generated. Topics omitted were mental health in the physician's home, crisis prevention/intervention, and troubled marriages. In 1992-1995, resident attendance ranged from 56%-79%. A minority (0-5 residents) consistently attended fewer than 50% of the conferences. Residents evaluated the conference from "good" to "very good." CONCLUSIONS: By employing a PBL format and allowing residents to present current patients, conferences were better attended and covered almost all topics previously identified as important. PBL promoted efficient use of residents' time since residents were only required to research the literature about group knowledge deficits. This provided good training for the residents and excellent continuing medical education for faculty.

Attitude of Health Personnel↗
PubMed1992

Role strain and depression in employed married Black mothers.

During the past several decades, the rate of participation in the labor force among married women with children has increased steadily. This trend coincides with an increase in the rate of reported psychological distress among women and an increase in researchers' interest in the psychological consequences of married mothers in the work force. Black women have historically and in significant numbers worked outside the home. The authors discuss the major concerns of employed Black mothers, identify areas where mental health professionals might intervene and identify coping strategies for Black women managing multiple roles.

Adaptation, Psychological↗
PubMed2007

Impact of marriage on HIV/AIDS risk behaviors among impoverished, at-risk couples: a multilevel latent variable approach.

Studies among normative samples generally demonstrate a positive impact of marriage on health behaviors and other related attitudes. In this study, we examine the impact of marriage on HIV/AIDS risk behaviors and attitudes among impoverished, highly stressed, homeless couples, many with severe substance abuse problems. A multilevel analysis of 368 high-risk sexually intimate married and unmarried heterosexual couples assessed individual and couple-level effects on social support, substance use problems, HIV/AIDS knowledge, perceived HIV/AIDS risk, needle-sharing, condom use, multiple sex partners, and HIV/AIDS testing. More variance was explained in the protective and risk variables by couple-level latent variable predictors than by individual latent variable predictors, although some gender effects were found (e.g., more alcohol problems among men). The couple-level variable of marriage predicted lower perceived risk, less deviant social support, and fewer sex partners but predicted more needle-sharing.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Partnership history and mental health over time.

STUDY OBJECTIVE: To describe the mental health of men and women with differing histories of partnership transitions. DESIGN: Data from nine waves of the British Household Panel Survey, a stratified general population sample, were used to calculate age standardised ratios and 95% confidence intervals for mean General Health Questionnaire scores for groups with different partnership transition histories. PARTICIPANTS: 2127 men and 2303 women aged under 65 who provided full interviews at every survey wave. MAIN RESULTS: Enduring first partnerships were associated with good mental health. Partnership splits were associated with poorer mental health, although the reformation of partnerships partially reversed this. Cohabiting was more beneficial to men's mental health, whereas marriage was more beneficial to women's mental health. The more recently a partnership split had occurred the greater the negative outcome for mental health. Women seemed more adversely affected by multiple partnership transitions and to take longer to recover from partnership splits than men. Single women had good mental health relative to other women but the same was not true for single men relative to other male partnership groups. CONCLUSIONS: Partnership was protective of mental health. Mental health was worse immediately after partnership splits, and the negative outcomes for health were longer lasting in women. Future work should consider other factors that may mediate, confound, or jointly determine the relation between partnership change and health.

Adult↗