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PubMed2000

Sexual satisfaction among married women age 50 and older.

Correlates of sexual satisfaction were identified in a sample of older married women. A 70-item questionnaire was mailed to an age-stratified sample of 5,000 married persons, including 1,000 married women over the age of 50. Usable questionnaires were received from 148 participants (14.8% return rate). Hierarchical multiple regression analysis, using sexual satisfaction as the dependent variable, yielded five predictor variables that accounted for a significant portion of the variation in sexual satisfaction (Cumulative R2 = .73). These results serve as a reminder that sexual interactions cannot be compartmentalized but must be considered within the context of the overall marriage relationship. Given the low return rate, interpretations should be limited until replication with an adequate sample has been completed.

Adult↗
PubMed2000

X-linked hyper IgM syndrome: a report of the first case in Thailand with a confirmed mutation of CD40 ligand gene.

UNLABELLED: X-linked hyper IgM (XHIM) syndrome is a rare congenital immunodeficiency disease caused by failure of B cell to isotype switch from IgM to other classes of immunoglobulins in response to infections. Recently, a molecular cloning of the gene responsible for the syndrome, the CD40L gene has been accomplished and the gene was successfully mapped to the long arm of X chromosome at the position Xq26. We, herein, report the first case of molecular proven XHIM in a Thai boy with a classic presentation and with a confirmed mutation of the CD40L gene. CASE REPORT: A.S. was a 1 year 7 month old boy referred from Buriram Provincial Hospital for a work up and treatment for his recurrent infections consisted of chronic respiratory tract infections with otitis media (since 6 months of age), chronic diarrhea (since 9 months of age) and malnutrition (marasmus) secondary to his longstanding illnesses. He was a product of a consanguineous marriage but without history of similar illness observed in his pedigree. Abnormal laboratory works up included IgG of 300 mg/dl, IgA 10 mg/dl, IgM 1,635 mg/dl, positive stool examinations for Cryptosporidium, chronic colitis on radiographic gastrointestinal follow through study, a positive acid fast bacillus (AFB) stain of gastric aspirate and multiple positive bacterial cultures from various body sources. His anti-HIV serology was negative. His hospital course was significant for several bouts of infections of gastrointestinal, respiratory, and genitourinary systems. His treatment consisted of multiple courses of antibiotics, antituberculous drugs and IVIG administrations. His hospital course was complicated with feeding problem from an esophageal stricture requiring several esophageal dilatations. The analysis of CD40L gene revealed a point mutation of exon 5 (A619T) of the CD40L gene resulting in a stop codon confirming that indeed he had XHIM. He died with Pseudomonas septicemia during the waiting period for a bone marrow transplantation from a cord-blood stem cell.

CD40 Ligand↗
PubMed1988

Women, work, and health: employment as a risk factor for coronary heart disease.

Employment as such does not appear to be a risk factor for coronary heart disease and may in fact have a beneficial effect on health. Although there is at present a paucity of reliable data, several key points emerge. In general, working women are in better health than homemakers or unemployed women. Single and married working women are apparently in better health than are divorced, separated, or widowed women. Among working women perception of control over the job environment may be a more important predictor of risk than level of job stress. Health appears to be compromised most among women who perceive little control over their lives. Although multiple social roles of wife, mother, and employee seem to enhance health, too much intensity in any one role may be detrimental.

Adolescent↗
PubMed1986

Psychological impact of infertility: identifying issues and needs.

During interviews, married couples experiencing infertility reported emotional reactions such as sadness, depression, anger, confusion, desperation, hurt, embarrassment, and humiliation. Behavioral reactions to infertility included disorganization, distractability, exhaustion, moodiness and obsessive thoughts and behaviors. Participants also described multiple sources of stress and utilized a variety of coping strategies. Implications for social work clinical and research practitioners are discussed.

Adaptation, Psychological↗
PubMed2000

[A case of Sipple syndrome whose bilateral pheochromocytomas were resected separately after a 3-year interval].

A 23-year-old woman who had undergone total thyroidectomy and parabronchial lymphadenectomy at the Department of Otolaryngology in our hospital was suspected to have a thyroid carcinoma. Histological examination revealed a medullary carcinoma of the thyroid and normal parathyroid glands. Because a computed tomographic scan after surgery revealed a tumor of the left adrenal gland, the patient was examined at our department two months after the thyroidectomy, 1994. Endocrinic examinations and 123I-MIBG scintigraphy revealed a left adrenal pheochromocytoma of Sipple syndrome. She then underwent left adrenalectomy. Histological diagnosis was pheochromocytoma of the left adrenal gland. Three years after the surgery, a right adrenal tumor was detected by computed tomography. Although results of endocrine examinations were normal, 131I-MIBG scintigraphy showed a hot spot in the right adrenal gland. Right adrenal pheochromocytoma was diagnosed 3 years after surgery for a contralateral adrenal pheochromocytoma. Although surgery was recommended, the patient consented to right adrenalectomy, 1 year later after marriage and before becoming pregnant. Histological examination of the resected specimen revealed pheochromocytoma of the right adrenal gland.

Adrenal Gland Neoplasms↗
PubMed1996

Employed Mexican women as mothers and partners: valued, empowered and overloaded.

This study was designed to explore the daily lived experiences of a group of employed, low-income Mexican women in their maternal and spousal roles. The participants were 41 auxiliary nurses recruited from two large urban hospitals in Mexico. Data were collected through the Women's Roles Interview Protocol (WRIP), which solicited the participants' perceptions of the satisfaction and stresses they experienced in their roles as mothers and spouses, and their descriptions of the coping strategies and the resources they used to deal with stressful life experiences related to these roles. Data analysis consisted of a qualitative thematic analysis of the narrative responses to open-ended questions in the WRIP. Satisfying aspects of the maternal and spousal roles, as identified by the participants, included giving to and receiving from their children and being valued and supported by their partners. Spousal approval of their work was also satisfying. These employed mothers, however, experienced many stressful aspects of functioning in multiple roles, including lack of resources, being absent from their children, self-doubt about their maternal role functioning, role overload and spousal absences. The women coped by juggling priorities and utilizing family resources. From the data analysis, the investigators developed a conceptual framework for understanding these women's experiences with parenting and marriage. The centrality of the family, a sense of value and empowerment as women in maternal and spousal roles, and the reality of role overload are discussed within the Mexican culture context of machismo, its female counterpart hembrismo, and family life. Implications for women's health are framed within a context of family and work.

Adaptation, Psychological↗
PubMed2006

Millimeter-wave antireflection coating for cryogenic silicon lenses.

We have developed and tested an antireflection (AR) coating method for silicon lenses used at cryogenic temperatures and millimeter wavelengths. Our particular application is a measurement of the cosmic microwave background. The coating consists of machined pieces of Cirlex glued to the silicon. The measured reflection from an AR-coated flat piece is less than 1.5% at the design wavelength. The coating has been applied to flats and lenses and has survived multiple thermal cycles from 300 to 4 K. We present the manufacturing method, the material properties, the tests performed, and estimates of the loss that can be achieved in practical lenses.

Journal Article↗
PubMed2003

Prospective study of hearing loss in schools for deaf children in Assir region, Saudi Arabia.

In this prospective study, various types and etiology of hearing loss among children attending public schools for the deaf were examined. One hundred students from two schools below the age of 15 years were enrolled in the study. Questionnaire was sent to all parents. Multiple modalities of investigations of hearing impairment in the children were performed. Out of the 100 students 78 (78%) had sensorineural hearing loss (SNHL) which was congenital in origin while in (22%) SNHL was acquired as a result of infancy or childhood infection. Forty one cases (41%) were born as a result of consanguineous marriages. Thirty two cases (32%) had a family history of deafness. Ninety (90%) of the students were found to have moderate to severe SNHL. The majority of these children were found to have no hearing aids and some of them were using non-functional hearing aids. Preventive methods through education of the public remain mandatory to minimize the incidence of SNHL. We recommend continuous monitoring and evaluation in association with appropriate care and rehabilitation for these children in order to achieve an acceptable level of speech and literacy.

Child↗
PubMed1998

[Genetic-demographic structure and prevalence of congenital malformations in rural regions of the Kursk district].

Investigation of the the genetics, demography, and epidemiology of congenital malformations (CMs) in Kursk oblast revealed statistically significant correlations between population parameters and the incidence of CM in the rural rations of the oblast. The general prevalence of CM and that of the separate CM forms ("guard" CM, multiple CM, hemangioma, congenital heart disease, congenital myelocele, talipes valgus, congenital femoral luxation, polydactyly, cryptorchism) increased with an increase in the average marital age of men and women of the reproductive part of the population and with an increase in the level of the populations homozygosity (an increase in the local consanguinity and ethnic marriage assortativeness, a decrease in the populations's migration activity, an increase in the proportion of genotypes homozygous for recessive genes, etc).

Congenital Abnormalities↗
PubMed1999

Sexual dysfunction in multiple sclerosis: II. Correlation analysis.

Sexual dysfunction affects a large part of patients suffering from multiple sclerosis, but some aspects of its clinical presentation and aetiology are not clearly defined yet. In an unselected sample of 108 patients with definite multiple sclerosis we investigated the relationship between symptoms of sexual dysfunctioning and sphincteric dysfunction, patients' and disease characteristics, disability and neurological impairment, psychological and cognitive functioning. Sexual dysfunction directly correlated with presence of physical disorders (r=0.37, P=0.0004), low educational level (r=0.32, P<0.002), disability (r=0.31, P<0.003), age at onset of symptoms (r=0.30, P<0.003), sphincteric dysfunction (r=0.30, P<0.003), age (r=0.30, P<0.004), depression (r=0.29, P<0.005), fatigue (r=0.29, P=0.005), cognitive deterioration (r=0.26, P<0.01), primary-progressive course of disease (r=0.25, P<0.02), neurological impairment (r=0.25, P<0.02), marriage (r=0.24, P<0.02), anxiety (r=0. 23, P<0.03), male gender (r=0.22, P=0.03) bladder dysfunction (r=0. 29, P<0.04), and unemployment (r=0.21, P<0.04). Sexual dysfunction correlated inversely with relapsing - remitting course of disease (r=-0.31, P<0.002). No correlation was found between sexual dysfunction and bowel dysfunction, duration of disease, secondary-progressive course of disease, number and frequency of sexual intercourses in the last year, number of partners, number of exacerbations in the last year, number of months since last exacerbation, masturbation, and fertility. In conclusion, the association between sexual dysfunction and sphincteric dysfunction indicates a common aetiology corresponding to the frequent involvement of the spinal cord in multiple sclerosis, but the concomitant correlation between sexual dysfunction and other variables suggests the possible aetiological role of physical, psychological and sociological factors as well.

Adult↗
PubMed2004

Impact of a cancer registry-based genealogy service to support clinical genetics services.

In collaboration with the network of genetics clinics in Scotland, a brief questionnaire was designed to gather data prospectively about the impact of information arising from pedigree research provided by Scottish Cancer Registry personnel. Pedigree research in Scotland is facilitated by access to public records of births, deaths, marriages, and historic census returns up to 1901, and enables the construction of accurate and extensive family pedigrees encompassing generations beyond the detailed knowledge of the proband. Subject to existing confidentiality guidelines, linkage of these pedigrees to cancer registration records results in a more comprehensive family history including the age at diagnosis of any cancer, multiple primary cancers, and cancers unreported from death certificates. Of 454 requests for pedigree research completed between 1 April 2002 and 31 March 2003, questionnaires were returned for 425 (94%). The information fed back to genetics clinics led to changes in family history, risk categorisation, and management in 41%, 30%, and 23% of cases, respectively. Management advice altered in both directions, that is, to institute active follow-up and surveillance of clinic attendees and their relatives where none was previously envisaged, and viceversa. The interests of current and future generations of patients concerned about their familial risk of cancer will be served by measures which enable cancer registries to collect data that are as accurate and complete as possible.

Data Collection↗
PubMed1994

The relationship of marital quality and psychosocial adjustment to heart disease.

Psychosocial adjustment to heart disease is variable. Some patients recover from a myocardial infarction or cardiac surgery quickly, return to work and leisure activities, and experience little emotional distress. Others suffer significant problems in psychosocial adaptation. We proposed and tested a theoretical model of adjustment that included the quality of the marital relationship, dysphoria, chronologic age, and time from the cardiac event (myocardial infarction or surgery) to identify the role that these variables play in adjustment. The study was conducted in 198 men diagnosed with coronary heart disease using the following instruments: the Spanier Dyadic Adjustment Scale, the Multiple Affect Adjective Checklist, and the Psychosocial Adjustment to Illness Scale. Data were collected on entry into the study and 3 months later to identify the stability of the relationships over time. The theoretical model was supported. Findings demonstrated that positive psychosocial adjustment to illness is influenced both by the quality of the patient's marriage and dysphoria. The spouse appears to influence psychosocial adjustment in an indirect manner by influencing the patient's experience of emotional distress or dysphoria. Nurses can enhance psychosocial adjustment to coronary heart disease by helping patients and spouses focus on ways to improve the quality of their marriage and by suggesting strategies to improve marital communication and decrease fear and misconceptions related to the illness.

Adult↗
PubMed1997

Assessing the impact of adolescent pregnancy and the premarital conception stress complex on birth weight among young mothers in Gibraltar's civilian community.

PURPOSE: The objective of this study was to assess the impact of young maternal age and the timing of conception on birth weight among primiparous women living in Gibraltar. METHODS: The data for this study were derived from a population of 295 primiparous women who gave birth under 25 years of age. Only married women who had no previous maternal history and delivered live singleton newborns between 1980 and 1984 were included. The confounding effects of gestation length, sex, and socio-economic status on birth weight were taken into account using the multivariate technique of multiple classification analysis. A conception timing variable was constructed and partitioned into four groups which represented the separate and joint effects of maternal age and prenuptial stress on birth weight. RESULTS: The overall mean birth weight was 3344.15 g. After controlling for the specified factors and covariate, the infants of older mother (> 19) who conceived after marriage weighed 57.78 g above the referent group mean. Older mothers who conceived a child before marriage delivered infants weighing 75.67 below the grand mean. Young mother (< 20) who conceived within marriage had infants who weighed 37.32 g less than the grand mean. Infants delivered by young mothers who conceived before marriage weighed 133.66 g less than the overall mean birth weight. The only significant group difference detected within the conception timing variable was between young mothers who conceived before marriage versus older mothers who conceived after marriage. CONCLUSIONS: Premarital conception is identified as a risk factor for lower infant birth weights among mothers under 20 years of age. This study emphasizes the need to take into account the effects of culturally mediated behavior on the pregnancy experience of young women.

Adolescent↗
PubMed2005

Husbands and wives living with multiple sclerosis.

Multiple sclerosis (MS) frequently is diagnosed in young adults. Coping with symptoms of MS is challenging not only for the person with the disease, but also for his or her spouse. The well spouse often assumes the caregiving role. The purpose of this qualitative research was to investigate the experiences of persons whose spouses have MS. Twelve people participated in a 2-hour focus group: 8 men and 4 women. The husbands were, on average, 50 years old, and the wives averaged 55 years old. The length of time since diagnosis ranged from 2 to 11 years for the husbands and from 3 to 13 years for the wives. The focus group discussions were audiotaped and transcribed verbatim. Participants talked freely. Four major themes emerged: caregiver roles, need for information, relationship changes, and barriers. Men attempted to protect their wives' energy, intervening for them. Wives encouraged independence in their husbands. Spouses need information about MS, complementary interventions, and support. They want increased public awareness of invisible symptoms and awareness in the workplace of continuing capabilities of persons with MS. Role reversals were challenging for the women who felt that "MS is the third person in a marriage." Spouses need help to maintain appropriate boundaries. Limitations of the study include the small, economically homogeneous sample and the single encounter with the subjects. A longitudinal intervention study is needed.

Adaptation, Psychological↗
PubMed2006

Ectrodactyly with aplasia of long bones (OMIM; 119100) in a large inbred Arab family with an apparent autosomal dominant inheritance and reduced penetrance: clinical and genetic analysis.

Ectrodactyly with aplasia of long bones syndrome is one of the most recognizable defects involving the extremities. We have studied a very large eight-generation consanguineous Arab family from the United Arab Emirates (UAE) with multiple severe limb anomalies resembling this condition (OMIM; 119100), for which the affected gene is unknown. The pedigree consists of 145 individuals including 23 affected (14 males/9 females) with limb anomalies. Of these, 18 had tibial aplasia (TA) usually on the right side. The expression of the phenotype was variable and ranged from bilateral to unilateral TA with ectrodactyly and other defects of the extremities. The mode of inheritance appears to be autosomal dominant with reduced penetrance. There were 10 consanguineous marriages observed in this pedigree. This could suggest possible pseudodominance due to high frequency of the mutant allele. Candidate loci for the described syndrome include GLI3 (OMIM: 165240) on 7p13, sonic hedgehog; (OMIM: 600725) on 7q36, Langer-Giedion syndrome (OMIM: 150230) on 8q24.1 and split-hand/foot malformation 3 (OMIM: 600095) on 10q24. In addition, bilateral tibial hemimelia and unilateral absence of the ulna was previously observed to co-segregate with deletion of 8q24.1. Two-point linkage and haplotype analyses did not show the involvement of the above regions in this family.

Abnormalities, Multiple↗
PubMed1995

Statistical and genetic aspects of quality control for DNA identification.

Quality control for likelihood ratio (LR) tests on restriction fragment length polymorphisms (RFLPs) and polymerase chain reaction (PCR) markers is provided by the 4N6 program. Examples are given for test of exclusion, coincidence, and kinship that should be used routinely in validation of DNA profiling. They confirm that "in a knowledgeable court DNA profiling is no longer exposed to risk of illogical presentation, blind acceptance or arbitrary rejection" (N. E. Morton, Eur. J. Hum. Genet. 1993, 1, 172-179). However, they remain to be implemented in national systems of quality control. There can be no effective quality control until attempts to fudge gene frequencies in order to retain the Hardy-Weinberg assumption (recommended by the National Research Council) ar abandoned in favour of the population genetic approach that takes gene frequencies from a real population and uses kinship to express genotype probabilities. Since an expert witness cannot know the identity of the culprit, he is obliged to consider multiple hypothesis without usurping the prerogative of the court to favour one of them on the basis of other evidence. It remains to be seen whether the new NRC Committee (and more importantly the international community of forensic scientists) will adopt this fundamental principle, which is especially important in populations like India with preferential endogamy and consanguineous marriage. Alternative procedures and the causes, effects, and remedies of four types of error are also considered.

DNA Fingerprinting↗
PubMed1998

Analysis of survival data with multiple causes of failure: a comparison of hazard- and logistic-regression models with application in demography.

"The purpose of the paper is to compare results of estimation and inference concerning covariate effects as obtained from two approaches to the analysis of survival data with multiple causes of failure. The first approach involves a dynamic model for the cause-specific hazard rate. The second is based on a static logistic regression model for the conditional probability of having had an event of interest. The influence of sociodemographic characteristics on the rate of family initiation and, more importantly, on the choice between marriage and cohabitation as a first union, is examined. We found that results, generally, are similar across the methods considered. Some issues in relation to censoring mechanisms and independence among causes of failure are discussed."

Family Characteristics↗
PubMed1992

Patients who use drugs during inpatient substance abuse treatment.

OBJECTIVE: Drug use by patients during inpatient substance abuse treatment is frequently a cause of premature hospital discharge. The authors examined the histories of patients who used drugs while in inpatient substance abuse treatment, the methods used to detect drug use, and the temporal relationship of drug use episodes. METHOD: The authors reviewed the charts of patients admitted consecutively to an inpatient substance abuse treatment unit between 1981 and 1988. Of 729 patients, 42 were found to have used drugs while receiving inpatient treatment. The diagnoses and clinical histories of these 42 patients were compared with those of all other patients. Methods of detection and circumstances of drug use were recorded, and drug use episodes were plotted on a time line that was examined for temporal clustering. RESULTS: Significantly more of the patients who used drugs during inpatient substance abuse treatment had primarily used heroin or methadone before treatment. Random urine screens, self-report, and staff observation together detected approximately 85% of the patients who used drugs during treatment. Episodes of drug use did cluster in time, but within clusters the hospital stays of the patients who used drugs did not necessarily overlap. CONCLUSIONS: Temporal clustering of drug use episodes may occur because drug use by one patient heralds drug availability and stimulates craving in other inpatients. Clinicians should be aware that one episode of drug use may be followed by others. Multiple detection methods, including random comprehensive urine screens, should be used to test for drug use on inpatient units.

Adult↗