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Family structure and relationships of 50 female anorexia nervosa patients.

Family features of the first 50 anorexia nervosa patients referred to a psychiatrist from a defined geographic area are documented. Information about the families was obtained from personal interviews with the parents during the course of the patients' treatment. High socio-economic class, absence of non-white population, older age of parents, instability factors in the parents' backgrounds and high incidence of both physical and psychiatric illness in the parents suggest multiple factors may be aetiological. Possible pathogenic factors are equally distributed between mothers and fathers.

Adolescent↗

Alcohol and the continuation of early marital aggression.

BACKGROUND: Husband alcohol use has frequently been found to be related to husband-to-wife marital violence. Research has demonstrated a prospective link between husband alcohol use before marriage and husband-to-wife aggression in the first year of marriage. The present study examined the relationships of husband violence, marital conflict, and couple's alcohol use in the first year of marriage to husband-to-wife marital violence in the second and third years of marriage. METHODS: Newlywed couples were recruited at the time of marriage and were interviewed regarding alcohol use and experience with violence before marriage, 1 year after marriage, and 3 years after marriage. RESULTS: Year 1 violence was predictive of subsequent marital violence. Husband and wife drinking patterns in the first year of marriage interacted to predict violence in later years. The most violence in subsequent years occurred in couples where the husband was a heavy drinker and the wife was not. Husbands who were violent in year 1 were more likely to be violent in later years. When no violence occurred in the first year, frequent use of verbal aggression in year 1 was predictive of violence in subsequent years. CONCLUSIONS: The predictive value of husband drinking patterns for subsequent violence extends beyond the transition to marriage. The fact that husband and wife alcohol use interacted to predict future aggression suggests that the relationship between husband alcohol use and marital violence is not spurious nor the result of conflict and violence promoting alcohol use. The findings may reflect multiple instances of acute intoxication and/or alcohol-related stress and conflict within the relationship, both of which may increase the likelihood of aggression.

Adult↗

Consanguinity as risk factor for cervical carcinoma.

Cervical carcinoma is caused by human papillomavirus (HPV). Among the risk factors for HPV infection are having multiple sex partners and sex partners who themselves had multiple sex partners. Women married to relatives are more likely to become infected with HPV and develop cervical carcinoma. Consanguineous spouses have a mild sexual aversion to each other that leads to sex avoidance and increases likelihood of satisfying sexual desire outside the marriage. Sexual aversion develops as a result of spouses growing together in early childhood, which triggers biological imprinting of Westermarck. Westermarck's effect prevents incest in nuclear family. In consanguineous family, it extends to spouses, producing mild sexual antipathy. Because of high prevalence of consanguinity worldwide, it is important to test this hypothesis.

Carcinoma↗

Auxiliary nurses in Mexico: impact of multiple roles on their health.

As more women worldwide enter the labor force, debate has been generated over how this additional work role influences women's health. In this study, we explored the work, maternal, and spousal roles of 59 auxiliary nurses in two university-affiliated Mexican hospitals. Participants completed questionnaires that included demographics, a women's roles interview protocol, a self-rating of health status, and the Cornell Medical Index (CMI). No significant correlation was found between the perception of their health status and the number of roles, amount of role involvement, or their perceived levels of stress and satisfaction in any of their three roles. Work stress was significantly correlated with the number of physical symptoms (r = .30, p < .05), longer periods of standing (r = .31, p < .05), more muscle strain (r = .53, p < .01), eye problems (r = .43, p < .01), frequent changes in environmental temperature (r = .30, p < .05), and perceptions of economic inadequacy (r = .37, p < .01). Years of education was not related to any health measure or degree of stress or satisfaction in any of the roles. The greater the degree of role integration, that is, the greater the sum of satisfactions minus stresses of each role, the fewer the physical symptoms (r = .48, p < .05) and the fewer total symptoms (r = .43, p < .05) reported on the CMI. Those with more spousal stress reported more work-related muscle strain (r = .35, p < .05), and working mothers with three or more children tended to perceive themselves as less healthy (r = .75, p < .01). Thus, analyzing the interrelationship of women's multiple roles is a better predictor of health than examining specific role stresses in isolation.

Adult↗

Identifying causes of disagreement between self-reports and spouse ratings of personality.

Self-reports and spouse ratings of personality traits typically show less-than-perfect agreement, but powerful moderators of agreement have not yet been identified. In Study 1, 47 married couples completed the Revised NEO Personality Inventory to describe themselves and their spouses. Extent of agreement was not consistently moderated by response sets; the age, intelligence, or education of the respondent; or the length or quality of the relationship. In Study 2 these couples were interviewed about reasons for substantial disagreements, and an audiotape was content-analyzed. Sixteen reasons were reliably coded, including idiosyncratic understanding of items, reference to different time frames or roles, and unavailability of covert experience to the spouse. Faking good, assumed similarity, and other variables prominent in the psychometric literature were relatively unimportant. Findings (1) suggest that attempts to improve the validity of self-reports and ratings may need to be refocused and (2) underscore the desirability of routinely obtaining multiple sources of information on personality.

Adult↗

Symptom reporting in wanted and unwanted pregnancies.

This study examined the association between unwanted pregnancy and the reporting of pregnancy symptoms in a sample of 99 pregnant women drawn from an urban, medical school based family practice residency. Of these women, 51 had unwanted pregnancies, and 48 had wanted pregnancies. Women with wanted pregnancies were more likely than women with unwanted pregnancies to report three pregnancy symptoms (amenorrhea, breast tenderness, and morning sickness). This association of symptoms with a wanted pregnancy persisted after controlling for age, race, marital status, contraceptive use, menstrual irregularity, and days since last menses through multiple logistic regression. Findings suggest that symptoms may be underreported by women with unwanted pregnancies.

Amenorrhea↗

The orthopaedic aspects of multiple epiphyseal dysplasia.

Five cases of multiple epiphyseal dysplasia (MED) were treated from 1985-1996 at the Orthopaedics and Trauma Department of SSK Izmir Educational Hospital. Four patients were female and one was male. The pedigrees of the first two female patients had the same features of inter-related marriages. The patients have been followed up for 5.5-11 years (average of 7.5 years). Surgical operations were mostly required in the lower limbs. Problems in the hips required adductor myotomy, the Soutter procedure, total hip replacement, and pertrochanteric extension osteotomy. Management of the knees required supracondylar shortening and extension osteotomy of the femur, high tibial extension osteotomy, debridement of the knee joint with removal of osteophytes, ogleotomy of the patellar lengthening of the knee flexors and posterior capsulotomy. Interphalangeal arthrodesis for hammer toes, extension osteotomy of the head of the first metatarsals, and Kellers operation were carried out in the foot. In the upper limb decompression and anterior transposition of the ulnar nerve, debridement of the elbow joint, extension and valgus osteotomy of the distal radius, and extension osteotomy of the head of the first metacarpal were required.

Adult↗

Prevalence of primary infertility in China: in-depth analysis of infertility differentials in three minority province/autonomous regions.

Following the 1994 UN International Conference on Population and Development, there was a shift in emphasis on women's reproductive health and there emerged a need for more knowledge about levels and differentials of infertility. Using the data from the 1988 National Two-Per-Thousand Sample Survey on Fertility and Contraception, this paper estimated the prevalence of primary infertility in China. To determine the predictors of primary infertility, multiple logistic regression analyses were done on three minority province/autonomous regions where primary infertility was the highest. A non-contracepting, sexually active woman was considered to have primary infertility if she had not reported a recognized pregnancy after at least seven years of marriage. The analysis shows that the national level of primary infertility was relatively low (1.3%). Primary infertility was higher in Qinghai (2.3%), Tibet (3.7%) and Xinjiang (3.7%) compared with other provinces. Tibetans in Qinghai and Uygurs in Xinjiang had a higher level of primary infertility than the Han Chinese. Ethnic differences remained after adjusting for other background characteristics. Divorced and remarried women had significantly higher odds of primary infertility compared with first-married women in Qinghai and Xinjiang. The elevated level of primary infertility in Qinghai, Tibet and Xinjiang and its disproportionate prevalence among Tibetans and Uygurs highlight the need for further work to understand the causes and social consequences of infertility for the minority population in China.

Adolescent↗

Risk factors for breast cancer in Pakistani women aged less than 45 years.

BACKGROUND: There has been an increase in the incidence of breast cancer in previously low-risk Asian countries. It is important to identify the risk factors for Asian women, as little information currently exists for this population. AIM: The objective of the study was to determine risk factors for breast cancer among Pakistani women. SUBJECTS AND METHODS: 498 cases younger than 45 years were interviewed from 1 July 1997 to 31 December 1998 at two major cancer hospitals. Age-matched population-based controls were selected from two cities and two villages to represent urban and rural areas. For the variables under study, cases and controls were compared by t-test. Conditional multiple logistic regression models were applied to the data set. RESULTS: Women with BMI >or= 30, with a family history of breast cancer and who were parous were at increased risk. Among parous women risk factors included BMI >or= 30, being in a consanguineous marriage, later age at menarche, later age at first full-term pregnancy, high parity and a history of abortion. CONCLUSION: The risk factors identified for Pakistani women below 45 years were similar to those observed in other studies. However, obesity in pre-menopausal women and late menarche were not protective and consanguinity was identified as a risk.

Abortion, Induced↗

Twenty-year course of schizophrenia: the Madras Longitudinal Study.

OBJECTIVE: To follow up 90 first-episode schizophrenia patients after 20 years and to study the course of symptomatology, work, social functioning, and pattern of illness during this period. METHODS: The Present State Examination and the Psychiatric and Personal History Schedule were administered at fixed points during follow-up. The measures adopted to ensure a good follow-up rate (67%) after 20 years under adverse conditions are described. RESULTS: Complete data were obtained from 61 subjects; 16 had died, and 13 could not be traced. After 20 years, 5 patients had recovered completely, and another 5 were continuously ill. Most of the cohort had multiple relapses with or without complete remission between them. The Global Assessment of Functioning Scale showed that symptoms and social functioning in this sample approximated results from developing countries and were much better than those of developed nations. There were not many sex differences. Marriage and occupational rates were higher than those observed in many published reports. CONCLUSIONS: This is one of the few long-term follow-up studies from the developing world. It reveals a pattern of course and functioning distinctly better than that found in many such studies from the developed nations.

Adult↗

The impact of development and population policies on fertility in India.

This article examines the impact of development and population policies on fertility decline and regional variations in India during the 1970s. Indicators of development at the household level include female literacy and education, infant mortality, and poverty; at the village level they include availability of such social services as schools, medical facilities, and transportation and communication facilities. Multiple regression analysis of data aggregated at the state level demonstrates that conditions conducive to fertility decline include high adult female literacy and low infant mortality as indicators of social development, and high contraceptive use and, to a lesser extent, high female age at marriage as proximate determinants of fertility. There are reasons to believe that India's national family planning program contributed to the decline in fertility observed since the 1960s. The pace of fertility decline in the future will depend upon the pace of infant mortality decline, enhancement in female education, and improvements in family planning programs.

Birth Rate↗

A dominant-hereditary variation of the Pena-Shokeir syndrome; a case report.

Four children with the Pena-Shokeir syndrome are described. Apart from the classical manifestations of the syndrome: camptodactyly, ankyloses, facial anomalies, pulmonary hypoplasia, all four children had an extremely rigid skin. Possibly this rigidness of unknown origin led in these cases to fetal akinesia, which seems to be the explanation of the clinical manifestations of the syndrome. All children were born to one man, three in his first marriage, one in his second. Therefore this case report almost certainly presents a dominant-hereditary variation of the syndrome.

Abnormalities, Multiple↗

Sculpting present and future: a systemic intervention model applied to psychosomatic families.

We present a therapeutic intervention model for use with psychosomatic families. This method, the result of our extensive research on various psychosomatic disorders, uses family sculptures of the "present" and "future": each family member is requested to represent the family as it now "is," and how it "will be" in the future. We discuss the theoretical reasons for our choice of this method: (a) the opportunity to use a therapeutic language that is similar to the nonverbal language of the psychosomatic symptom, and (b) the usefulness of reinserting temporal dimensions into family systems that seem to have lost their evolutionary potential and to be in a sort of "time lock." Two clinical cases are discussed (a child with chronic asthma and an anorexic adolescent); the use of sculptures in both cases revealed the underlying problems and made positive therapeutic interventions possible. Finally, we point out how the use of sculpture as a therapeutic technique enables therapists to deal with multiple systemic levels.

Adolescent↗

Socioeconomic status and risk of HIV infection in an urban population in Kenya.

OBJECTIVE: To examine the relationship between socioeconomic status (SES), risk factors for HIV infection and HIV status in an urban population with high prevalence of HIV infection in sub-Saharan Africa. METHODS: Cross-sectional population survey of adults from the city of Kisumu, Kenya, in 1996. Around 1000 men and 1000 women aged 15-49 years were interviewed using a structured questionnaire, and most gave a venous blood sample for HIV testing. SES was represented by a composite variable of educational status, occupation and household utilities. Multiple regression was used to examine whether SES was associated with HIV infection or with risk factors for HIV infection. RESULTS: Human immunodeficiency virus prevalence was 19.8% in males and 30.2% in females. Higher SES was associated with a more mobile lifestyle, later sexual debut and marriage among both sexes, and with circumcision among men aged 25-49 and condom use among women aged 25-49. Higher levels of alcohol consumption were associated with an increased risk of HIV infection and were more common amongst those of higher SES. HSV-2 infection was strongly associated with an increased risk of HIV infection and was more common among those of lower SES. HIV was associated with a lower SES among females aged 15-24 whereas in males aged 15-24 and females aged 25-49 there was some indication that it was associated with higher SES. Among males aged 25-49 there was no association between HIV infection and SES. CONCLUSIONS: Risk of infection was high among groups of all SES. Risk profiles suggested men and women of lower SES maybe at greater risk of newly acquired HIV infection. New infections may now be occurring fastest among young women of the lowest SES.

Adolescent↗

The role of personality and other factors in a mother's decision to initiate breastfeeding.

The objective of the study was to measure the impact of personality and other factors on the decision to initiate breastfeeding. Mothers were enrolled (24-96 hours postpartum) and were classified as fully breastfeeding, formula-feeding, or combination-feeding. A semi-structured interview about maternal sociodemographics and attitudes and a standardized personality inventory (NEO-PI-R) were conducted. Eighty-seven mothers completed the study: 50 breastfeeders, 6 combination feeders, and 31 formula feeders. Because of small numbers, combination-feeder mothers (n = 6) were excluded from analyses. Maternal age, marriage, ethnicity, and socioeconomic status were significantly associated with breastfeeding. Breastfeeding and formula-feeding groups differed on 3 personality domains: extraversion (53.3 breastfeeding vs 46.9 formula-feeding, P = .002), openness (51.6 vs 46.2, P = .008), and agreeableness (48.5 vs 41.5, P = .01). In a multiple variable logistic regression model, extraversion (P = .03) and openness (P = .003) remained significant. Sociodemographics, experiential factors, and specific personality characteristics of mother were independently associated with maternal feeding decision.

Adult↗