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Cytomegalovirus and male infertility.

Male infertility may be due to a multiplicity of etiologic factors. In this study we have investigated the presence of cytomegalovirus (CMV) in 150 infertile men (selected after the exclusion of other etiopathogenic factors of infertility) and 80 subjects screened for pre-marriage consult. CMV was found in the sperm of 7/150 patients and 3/80 subjects screened for pre-marriage consult. Moreover, the seminal abnormalities evidenced in infertile men (a significant decrease of nemaspermic concentration and motility, of fructose, a significantly increased pH) were also observed in subjects screened for pre-marriage consult having CMV in the sperm. These abnormalities were related to alterations of cell-mediated immunity (decreased OKT4+, increased OKT8+ with decreased OKT4/OKT8 ratio). Among ten CMV+ subjects, two with idiopathic sterility and three subjects screened for pre-marriage consult showed a negativization of CMV in the sperm, during the observation period (one year), and a decreased anti-CMV titre lower than eight. Contemporary, a normalization of immunologic and seminal parameters was observed.

Adult↗

Sexual activity before marriage in sub-Saharan Africa.

Throughout sub-Saharan Africa there is notable concern about the consequences of premarital sexual intercourse, such as illegal abortions and pregnancy-related school dropouts, and the potential risk of HIV infection. Using data from the Demographic and Health Surveys, the authors investigated sexual activity among never-married women aged 15-24 in Botswana, Burundi, Ghana, Kenya, Liberia, and Zimbabwe. While there are important cross-country differentials, in most countries the majority of unmarried adolescents have been sexually active. Contrary to the common belief that teenage premarital sexual activity is a new phenomenon caused by socioeconomic development, particularly Western education, the data show that in most countries sexual activity among unmarried adolescents was also common in the past, and that increases across cohorts have occurred mostly in countries where the prevalence was already high. For most countries, there is little support for theories claiming that education is associated with loose morals and high levels of premarital sexual activity. The findings highlight the importance of family-planning services for unmarried adolescents and of family-life education in primary schools to reach children before they become sexually active.

Adolescent↗

Who's afraid of the Wolfe couple: the interlocking traumatic scene.

Fulfilling intimate relationships require a constant emotional and psychological struggle to disentangle strangleholds created by the interpenetration of unresolved complexes stemming from previous disappointing relational experiences. These complexes may manifest as an encrypted pattern of engagement that each partner brings to the marriage, like a 'malignant dowry'. The dowry box, once opened, releases its nefarious contents to create an extremely complex and entangled drama I call the 'interlocking traumatic scene'. Partners unconsciously entrap each other to play a part in such a scene with double (sometimes multiple) roles for each antagonist. The imaginal space between the two characters can be seen as a projection screen, upon which are superimposed two separate shadow plays, one on each side of the screen. A third play, which is a co-created product of these two individual traumatic scenes, can also be observed. Three plays are performed simultaneously. The defensive systems that the two individuals bring to the equation dovetail together, but the actual interlocking mechanism itself deadlocks in such a way that it seems to have its own malignant presence, a 'malevolent third' (after Ogden 1994). I outline therapeutic interventions using the metaphor of the therapist as 'anti-director' and I introduce my concept of the conjoint selected fact (after Bion 1963 after Poincaré 1952).

Fantasy↗

Sensorineural hearing loss in Jewish children born in Jerusalem.

OBJECTIVE: Many factors, hereditary and environmental, may cause deafness. The aim of the present study was to analyze data on the etiology of bilateral sensorineural hearing impairment in children born in the Jerusalem area during 1978-1991, and to compare the results to those of a previous survey (1968-1977) in the same area. METHODS: The study included 150 Jewish children (139 families) with hearing loss, born during 1978-1991. Information was obtained on prenatal, perinatal and postnatal events, history of hearing loss in the family, the parents' communities and consanguinity. Children with a sensorineural hearing impairment of 56 dB HL or greater in the better ear, within the frequency range of 0.5-4 kHz were included in the study. The hearing loss was classified as moderate-severe (56-70 dB HL), severe (71-90 dB HL) and profound (91 dB HL or more) in the better ear. Mutations in the coding sequence of the connexin 26 (C x 26) and the connexin 30 genes were examined in some of the families. RESULTS: The hearing impairment was hereditary in 66 (44%) of the children, environmental in 31 (21%) and four children (3%) had multiple malformations. The cause was unknown in 49 (33%) children. Sixty-two families were of European origin (Ashkenazim) and 62 of Afro-Asian origin (Sephardim). Consanguinity was in 7% of the families. Mutations in connexin 26 and the deletion in connexin 30 were diagnosed in 9/18 families tested. The incidence of hearing loss decreased from 1.28 per thousand during 1968-1977 to 1.06 per thousand during 1978-1991. The rate of environmental causes decreased over the years together with an increase in the rate of unknown causes. The rate of hearing loss among Sephardim decreased significantly and increased among Ashkenazim. CONCLUSIONS: The rate of hearing impairment in Israel is as that found in other countries, as was the distribution of the causes of deafness. The decrease in the rates of hearing impairment among the Sephardim may be due to a continuing decrease in consanguineous marriages among Sephardim. It is expected that the group of unknown causes will become smaller in future with the availability of more molecular genetic tests.

Abnormalities, Multiple↗

Health promotion activities among working and non-working adult women.

Self report measures of health promotion activities and demographic variables of working women and housewives were analyzed. A sample of 516 female clients (283 of housewives and 233 of working women) were chosen from nine different out patient clinics offering health services to women in Tanta city. Three structured questionnaire sheets were used, namely: (1) Health promoting life style questionnaire (HPLQ), (2) Health value scale (HVS), and (3) self-efficacy. The results showed that a minority of housewives and working women groups correctly tended to practice more health promotion activities. However, the total mean scores of working women were slightly higher ( 362.03 +/- 33.55 out of 522) than that among housewives group (332.77 +/- 31.18). Multiple regression analysis indicated a significant correlation between women scores regarding most of the studied items related to self reported health promotion activities and demographic variables. Higher education (p = 0.004), family income (p = 0.005), and duration of marriage (p = 0.031) were associated significantly with working women who sought more health promotion activities, while education (p = 0.003) and family income (p = 0.028) were associated significantly with housewives group. Finally, the present study proved that work of women (p = 0.000) significantly related to the practice of health promotion behaviors.

Adult↗

Understanding marital stressors. The importance of coping style.

Previous survey work with 1591 married Chicago adults has demonstrated a close connection between symptoms of depression and current marital stressors (nonfulfillment of basic role expectations, lack of reciprocity between partners, and nonacceptance by spouse). The pertinent question now becomes which factors predispose toward marital stressors. We address this issue here by examining a broad array of variables to see which are most predictive of marital stressors by employing multiple regression analysis on data from the survey sample. A descending order of explanatory power of marital stressors occurs for the following categories of variables: respondent's style of coping with marital problems, behavior patterns within the marriage, personality factors of the respondent, other current social stressors, demographic variables, and marital circumstances. One coping style in particular, that of optimistic action, is more predictive of low marital stressors than any other single variable studied. The findings contradict several common beliefs about marital stressors: the presence of background differences between the spouses, a lack of consensus between the partners, and the presence of other social stressors (job, parenting, finances) are relatively poor predictors of marital discord.

Adaptation, Psychological↗

[Study on health services needs and affecting factors of childbearing-age women of Jingsong Community in Beijing].

A household health interview survey was conducted in 1991 to study the special health problems, health care needs and affecting factors of child bearing-age women. 624 women were randomly sampled in Jingsong Community, Beijing. The results showed that two-week prevalence rate was 20.2 percent, the morbidity rate of chronic diseases was 25.3 percent. These two indexes were higher than the average level of Beijing's population. The medical care needs were great, but utilization of available services was inadequate. The common diseases and woman's diseases were still the major diseases. Preventive health service needs, such as premarriage counseling, postnatal care, women suffer, regular check-up and treatment of woman's diseases, family planning services etc., were not satisfactorily met. The results of the single and multiple variable analysis indicated that the health care needs were mainly affected by age, marital status, education, occupation, system of medical care insurance and position in family. Incidence of gynecopathy was associated with age of the first marriage, number of times of induced abortion etc.. Proposals on improving women's health care in urban community were also put forward in the paper.

Aged↗

Marital exogamy in the Aland Islands, Finland, 1750-1949.

Marriage records from 1750 through 1949 were used to examine effects of population size, geographic distance, and temporal change on rates of marital exogamy in the Aland Islands, Finland. Exogamy rates for individuals (not couples) were computed for 15 Aland parishes in each of four 50-year time periods, giving a total of 60 observations. These rates were analysed with respect to population size using a quadratic regression model. Regression analyses were also used to examine the relationship of marital exogamy with two measures of geographic distance--average distance to all other parishes and nearest-neighbour distance. Analysis of variance was used to examine temporal trends. Multiple regression analyses were used to examine all of these factors simultaneously. Marital exogamy is highest in smaller and larger populations, and less in medium-sized populations. Higher exogamy rates in small populations are related to the lack of available mates in small groups. Higher exogamy rates in larger populations may reflect economic attraction of larger groups. Exogamy rates are lower in the more geographically isolated parishes. From 1750 through 1899 there is little change in exogamy rates, whereas exogamy rates double after 1900. This temporal change reflects changes in transportation technology and other cultural factors promoting increased migration. The multiple regression model shows population size, geographic distance, and temporal change are all significant correlates of exogamy, collectively explaining a large percentage of variation in rates (R2 = 0.79).

Female↗

Marriage protection and marriage selection--prospective evidence for reciprocal effects of marital status and health.

Married adults are generally healthier than unmarried adults. It has been hypothesized that marriage is associated with good health because marriage has beneficial effects on health (marriage protection effects) and/or because healthier individuals are more likely to marry and to stay married (marriage selection effects). To investigate these hypotheses, this study analyzes prospective panel data for a large national sample of women in the U.S. (the National Longitudinal Surveys of Young Women). The women were aged 24-34 yr at the beginning of two successive five-year follow-up intervals. Analyses of the prospective data indicate that there were significant marriage protection effects, but only among women who were not employed. Specifically, for women who were not employed, married women had better health trends than unmarried women in each follow-up interval. It appears that marriage had beneficial effects on health for women who did not have a job which could provide an alternative source of financial resources and social support. In addition, analyses of the prospective data provide limited evidence for marriage selection effects. Specifically, women who had better health initially were more likely to marry and less likely to experience marital dissolution, but only for women who were not employed full-time and only during the first follow-up interval. Thus, the prospective evidence suggests that, for women who were not employed, both marriage protection and marriage selection effects contributed to the marital status differential in health observed in cross-sectional data. In contrast, neither marriage protection nor marriage selection effects were observed for women who were employed full-time. As would be expected, the cross-sectional data show that marital status differentials in health were large and highly significant for women who were not employed, whereas marital status differentials in health were much smaller and often not significant for employed women. Women who were neither married nor employed had particularly poor health. Additional evidence indicates that the women who were neither married nor employed suffered from multiple interacting disadvantages, including poor health, low incomes, and sociodemographic characteristics which contributed to difficulty in obtaining employment.

Adult↗

Social support during pregnancy: a unidimensional or multidimensional construct?

The purpose of this study was to test empirically a conceptually derived multidimensional formulation of social support. Analyses were based on responses of 313 expectant couples who varied in age, income, and education. A questionnaire, which included the Support Behaviors Inventory (SBI), was given in the latter half of pregnancy. A four-phased analysis was conducted: discriminate validity testing of the multidimensional support structure, further subscale analysis, factor analysis of the structure of the SBI, and reformulation of the SBI based on results of the factor analyses. Results did not demonstrate independence of measurement with items that were developed to represent a priori social support dimensions of emotional, material, informational, and appraisal support. The factor analysis in particular revealed that the scree test by Cattell (1966) demonstrated a large, dramatic discontinuity in eigen-values and suggested that there was only one systematic factor. These results implied a dominant construct of social support in pregnant couples that organizes at the broad level the perceived degree of experienced support during pregnancy. This broader concept was so dominant in the current study, explaining 48% of the variance in partner support and 61% of the variance in others support, that the idea of multidimensionality was not confirmed. These data suggest an ongoing need to scrutinize carefully and validate empirically the hypothesized multiple dimensions of social support proposed in a number of recent support instruments.

Adolescent↗

Relationship satisfaction of Mexican American and non-Hispanic white American interethnic couples: issues of acculturation and clinical intervention.

Despite the increasing prevalence of interethnic marriages, remarkably little empirical literature exists for guiding clinical interventions offered to these couples. This study compared the marriages of 72 couples with one Mexican-American partner and one non-Hispanic White American partner, 75 Mexican-American couples, and 66 non-Hispanic White couples. Overall, the interethnic couples were more similar to non-Hispanic White couples than they were to Mexican-American couples across multiple domains, with the latter group indicating modestly higher levels of relationship distress. Among interethnic couples, Mexican-American wives' level of acculturation related significantly to both their own marital- and parental-role orientation and to distress in their relationships with children, as well as to their husbands' marital distress regarding child rearing and the couple's interactions regarding finances. Implications for clinical interventions with Mexican- and White-American interethnic couples are discussed.

Acculturation↗

Statistics on alcoholic marriages: an overview.

This paper is a brief American literature review reporting on (1) the percentage of alcoholics who marry, (2) the percentage who separate or divorce, and (3) the temporal relationship between date of marriage and onset of alcoholism. All studies discussed control for age and compare results to a general population. The authors show that early studies suggested that alcoholics were an unsocialized and homeless group of people who were not likely to marry whereas later research showed that alcoholics are just as likely as persons in the general population to marry but are at least four times more likely to separate or divorce. Multiple variables account for the high rate of marital disruption. The literature is conflicting regarding whether people tend to marry before or after the onset of alcoholism. Future research must delineate relevant psychological and sociocultural variables in addition to the alcoholism itself.

Alcoholism↗

Job sharing: impact on the general well-being of female nurses.

Women today have more life choices than ever before: career, marriage, motherhood, or any combination of the three. Unfortunately little has been done to make up for the competing demands of these roles. Job sharing may be the alternative choice which allows working women to cope with the multiple stressors of having it all--career and family without having to sacrifice their sense of well-being. Nursing administrators stand to benefit from a work schedule alternative which promotes a healthy balance between work and family. Job sharing may offer a solution to the loss of valued staff nurses who require less than full-time employment. In order to compare the general well-being of female nurses who are employed in full-time, casual part-time, and job sharing positions a descriptive correlation study was conducted. One hundred female nurses between the ages of 22 and 40 who have their children living at home with them completed the 18-Item General Well-Being Questionnaire. Additional questions regarding job satisfaction, physical health status, and demographic data were also included. The results of the analyses of variances revealed there were no statistical differences between the general well-being scores of women working full-time, casual part-time, or job sharing. However, crosstabulations showed the job sharing nurses had the highest ratings for job satisfaction and physical health status.

Adult↗

Detrimental effects of onchocerciasis on marriage age and breast-feeding.

This paper examines the extent to which onchocercal skin lesions affect the age at marriage and the duration of lactation among infected women in forest areas of Nigeria. In a retrospective study, 145 multiparous women were asked about their breast-feeding behaviour. Ninety-seven per cent routinely breast-fed after delivery, although the duration of lactation for 75 infected and 70 non-infected women was different. Of the 75 women with Onchocerca volvulus infection, 73% experienced itching during breast-feeding; 26% breast-fed for not more than 3 months compared to 2.1% of non-infected women who breast-fed for the same period (p < 0.005). A multiple regression model showed severity of onchocercal lesions as an independent predictor of shorter duration of lactation for women with O. volvulus infection. Duration of breast-feeding was reduced by more than 9 months for 6 (25%) out of 24 infected women who breast-fed infants before and after the onset of itching from lesions. Also, while the minimum age at marriage was 9 years for non-infected women, it was 17 years for women whose lesions appeared before marriage. This preliminary study suggest that incessant itching and severe onchocerciasis lesions may be important predictors of failure of women to breast-feed for longer periods in rain-forest areas of Nigeria.

Adolescent↗

The Meckel syndrome in Finland: epidemiologic and genetic aspects.

Estimates of the incidence of the Meckel syndrome (MS) from different parts of the world vary from 1:140,000 to 1:13,250 births. In this nationwide study performed in Finland, the incidence of 1:14,400 births was found by retrospective ascertainment during the period 1970-1979, while the incidence was 1:8,500 births when prospective monitoring was performed in 1980-1981. The most probable incidence in Finland is about 1:9,000 births. Autosomal recessive inheritance of MS is confirmed in this study. The ratio of affected sibs, corrected for truncate complete ascertainment, was 0.261. No consanguinity between parents was found, as marriages between close relatives are rare in Finland and the ancestors were not traced back far enough to find remote consanguinities.

Abnormalities, Multiple↗

A postaxial polydactyly-dental-vertebral syndrome.

Three patients with postaxial polydactyly and other abnormalities of the hands and feet, hypoplasia and fusion of the vertebral bodies, and dental abnormalities are reported. Two were sisters born to normal unrelated parents; the other patient was the male offspring of a consanguineous marriage. We suggest that this constellation of abnormalities represents a recessively inherited syndrome.

Abnormalities, Multiple↗