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PubMedDate not supplied

The first diabetes educator is the family: using illness representation to recognize a multigenerational legacy of diabetes.

PURPOSE: This article proposes a framework for understanding multigenerational legacies of diabetes, which will assist with designing educational interventions for individuals with a known family history of type 2 diabetes. BACKGROUND/RATIONALE: Diabetes is a chronic illness that has an associated hereditary predisposition. Family members at risk in subsequent generations may be influenced by the prior generation's experiences. Multigenerational legacies and stories shape a family's health beliefs and response to illness and transmit patterns of adaptation across generations. METHOD: A review of the literature from 1984 to 2004 was conducted to identify evidence of legacies of chronic illness. OUTCOME: Family-systems-illness-disability Model and Theory of Illness Representation were used to guide the development of a framework of multigenerational legacies of diabetes. INTERPRETATION/CONCLUSION: A framework for understanding the influence of illness representation on multigenerational legacy of type 2 diabetes is presented. IMPLICATIONS FOR NURSING PRACTICE: Clinicians are in need of a useful framework that can provide direction as they attempt to understand the effect of a family history of diabetes on the health behavior of the next generation of family members with diabetes. This framework could serve to guide them as they probe for information relevant to the influence of recollections about the family member's experience with diabetes on an individual's health behavior.

Diabetes Mellitus, Type 2↗
PubMed1998

Grandparents' role in family systems with a deaf child. An exploratory study.

This qualitative study explored the role of grandparents in hearing/deaf family systems. Specifically, the grandparental role was examined in six family systems across at least three generations (grandparent, parent, deaf grandchild). The study's purpose was to provide insight into personal and interpersonal functioning of extended family systems with a deaf member and to provide a basis for future quantitative research. Results indicated that grandparents were willing to provide diverse support services to their children and grandchildren to the extent permitted by their resources and the nature of their existing relationship with the deaf child's parent(s). The advent of a deaf grandchild appeared to have strong effects on the extended family system, but typically system responses were consistent with the quality of preexisting relationships. Families with weak intrafamilial communication tended to have difficulties with incorrect assumptions. Families with unresolved individuation issues tended to replay these issues within the context of attempts to adapt to their changed circumstances.

Adolescent↗
PubMed1987

Economic policy, intergenerational equity, and the Social Security Trust Fund buildup.

For the next 75 years, the Old-Age, Survivors, and Disability Insurance (OASDI) system is projected to be close to in balance, on average. For approximately the next 40 years, under current projections, the combined OASDI Trust Fund is expected to continually have excesses of income over outgo, creating a buildup that will peak in 2030 at about +12 1/2 trillion (roughly 23 percent of the gross national product). Thereafter, the system is projected to be in annual deficit continually until the trust fund is exhausted in 2051. This article focuses on two fundamental issues that must be understood if the potential economic consequences of this buildup are to be evaluated properly. The first issue deals with the fact that the nature of Federal economic policy during the buildup period will determine the ultimate economic impact of the buildup. The second issue concerns the effect of the buildup, and its disposition, on the Social Security program's treatment of one generation of workers compared with another. If a fund is actually accumulated as projected, part of the retirement benefits of the "baby-boom" generation will, in effect, be self-financed. If, however, that fund is used for other purposes--directly or indirectly--future cohorts of workers will be required to fully finance benefits promised to the baby-boom retirees.

Aged↗
PubMed1996

Grandparents in Taiwan: a three-generational study.

Grandparents in the Republic of China want to remain influential, but social policy has not provided them with education to fulfill their changing role. The performance of grandparents was examined to determine suitable content for an intervention program. A sample of 751 non-consanguineous participants from urban and rural Taiwan included 234 grandparents, 241 parents, and 276 grandchildren. Each generation was administered a separate version of the Grandparent Strengths and Needs Inventory that was translated into Mandarin. Respondents identified favorable qualities of grandparents as well as aspects of their relationships in which growth was necessary. Multivariate analysis of variance, univariate analysis of variance, Scheffé and t-tests were used to analyze scores, confirm results, and facilitate interpretation. All three generations described aspects of grandparent success and specific realms of learning they should acquire to become more effective. Significant main effects that influenced responses about grandparent performance were generation, gender of grandchild, age of grandchild, frequency of grandchild care by grandparent, generations living together, and amount of time grandparent and grandchild spent together. Considerations were recommended to improve behavior of grandparents and guide the development of educational programs for them.

Aged↗
PubMed2001

Socioeconomic status and depressive syndrome: the role of inter- and intra-generational mobility, government assistance, and work environment.

This paper assesses the hypothesis that depressive syndrome is associated with socioeconomic status, using longitudinal data from the Baltimore Epidemiologic Catchment Area Followup. Socioeconomic measures include those used in most studies of status attainment, as well as measures of financial dependence, non-job income, and work environment. Analyses include inter- and intra-generational mobility, and replicate the basic aspects of the status attainment process, as well as psychiatric epidemiologic findings regarding gender, family history of depression, life events, and depressive syndrome. But the involvement of depressive syndrome in the process of status attainment, either as cause or consequence, is small and not statistically significant. There are strong effects of financial dependence and work environment on depressive syndrome. The findings shed doubt on the utility of the causation/selection/drift model for depression, to the extent it is based on linear relationships and socioeconomic rank at the macro level, while lending credibility to social-psychologically oriented theories of work environment, poverty, and depression.

Baltimore↗
PubMed1995

Grandparents in Japan: a three-generational study.

Grandparents in Japan believe that their status in the family is eroding. They want to be influential but social policy has not included education for their changing role. The purpose of this study was to identify strengths and needs of Japanese grandparents as perceived by three generations. Each generation completed a separate version of the Grandparent Strengths and Needs Inventory. Multivariate analysis of variance procedures were used to compare perceptions of 239 grandparents, 266 parents, and 274 school-age grandchildren from cities and small towns. Grandparents reported more satisfaction, greater success, and more extensive involvement in teaching than was observed by parents and grandchildren. Grandparents experienced greater difficulty, more frustration, and felt less informed to carry out their role than was reported by parents and grandchildren. Significant main effects that influenced responses about grandparent performance were generation, gender of grandchild, age of grandchild, generations living together, frequency of grandchild care by grandparent, and amount of time they spent together. Considerations were identified to improve grandparent behavior and guide the development of educational programs for them.

Aged↗
PubMedDate not supplied

Bridging the generation gap.

Generational differences will always exist among nurses and patients. However, with our limited resources, the aging of our patient population, and increased longevity, it is pivotal that we identify effective strategies to transcend generational differences that may compromise patient care. By joining forces, we can maximize our knowledge and skills and in the process enhance our ability to value the contribution of these generational differences to improve quality nursing care and rehabilitation practice. Although the solutions may not be simple, we must persist in discovering creative solutions to overcome the multiple conflicts emerging from patient and nursing generational differences.

Humans↗
PubMed2006

[Long-term effects of environmental endocrine disruptors on male fertility].

Several epidemiologic studies have demonstrated during the last 50 years an increased incidence in testis cancer, male genital tract malformations (cryptorchidism and hypospadias) and a decrease in sperm quality in men. These three pathologies seem to be linked and to belong to the testicular dysgenesis syndrome (TDS). It was suggested that TDS is a consequence of intra-uterine exposure to environmental compounds that disrupt the metabolism of native hormones. Such substances are so called endocrine disruptors (EDs). EDs are present in our daily environment such as food and water (through the use of pesticides), cosmetics, house-care products etc. Experimental models have been carried out to (i) establish a link between EDs exposure and SDT and (ii) identify the mechanisms that are involved in. After a brief definition of EDs and having underlined the importance of the window of exposure to EDs, several mechanisms will be described such as (i) intergenerational transmission (epigenetic), (ii) programmed cell death of testicular cells, (iii) modification of the androgenic signal and (iv) role of the germ cells-nourishing cells. To conclude, we will try to propose some biomarkers that would be useful to identify the potential link between fetal exposure to anti-androgenic EDs and male testicular pathology.

Androgen Antagonists↗
PubMed2004

Ageism and death: effects of mortality salience and perceived similarity to elders on reactions to elderly people.

The present research investigated the hypotheses that elderly people can be reminders of our mortality and that concerns about our own mortality can therefore instigate ageism. In Study 1, college-age participants who saw photos of two elderly people subsequently showed more death accessibility than participants who saw photos of only younger people. In Study 2, making mortality salient for participants increased distancing from the average elderly person and decreased perceptions that the average elderly person possesses favorable attitudes. Mortality salience did not affect ratings of teenagers. In Study 3, these mortality salience effects were moderated by prior reported similarity to elderly people. Distancing from, and derogation of, elderly people after mortality salience occurred only in participants who, weeks before the study, rated their personalities as relatively similar to the average elderly person's. Discussion addresses distinguishing ageism from other forms of prejudice, as well as possibilities for reducing ageism.

Adolescent↗
PubMed2006

An investigation of potential Holocaust-related secondary traumatization in the third generation.

This study investigated whether grandchildren of Holocaust survivors placed in concentration camps were more prone to PTSD symptoms than grandchildren of Jewish non-immigrants (native-born) and grandchildren of Non-Jewish immigrants. It has been well established that PTSD symptoms can be transmitted from Holocaust survivor parents to their children. Previous research has not yet established whether an identical transmission of PTSD symptoms can occur from the second generation to the third. The measures employed in conducting this study were the Secondary Trauma Scale (STS), the Impact of Events Scale-Revised (IES-R), the State-Trait Anxiety Inventory (Form Y) (STAI), and a Modified Stroop Procedure which was comprised of colored Holocaust trauma-related words, positive words, neutral words and obsessive compulsive disorder words. Results indicate that all three groups exhibited longer response latency for the PTSD Holocaust-related stimuli card thereby indicating an increased sensitivity across all populations regardless of race or religion. The grandchildren of Holocaust survivors and the grandchildren of Non-Jewish immigrants scored significantly higher than the grandchildren of Jewish Americans on the Secondary Trauma Scale as well as the Avoidance subscale of the IES-R. This finding suggests a possible immigration effect for these groups. There were no other significant differences across the other measures employed in this study. These conclusions can be construed as persuasive evidence that, with respect to Holocaust-induced secondary trauma, the residual impact is diminished to such an extent by the third generation that the differences between grandchildren of Holocaust survivors and the overall population are statistically non-significant.

Adolescent↗
PubMed1982

Effects of carcinogens and partial hepatectomy upon the hepatic O6-methylguanine repair system in mice.

The enhanced repair of O6-methylguanine from hepatic DNA in rats is a well established phenomenon that can be induced by pretreatment with a variety of hepatotoxic agents as well as by partial hepatectomy. Attempts to induce a similar hepatic response by treatment with single doses of aflatoxin B1 in C57Bl mice, single doses of dimethylnitrosamine (DMN) in C57Bl or BALB/C mice or by prolonged pretreatment with DMN by addition to the drinking water of C57Bl mice were uniformly unsuccessful. Furthermore, the intense proliferative response induced by two-thirds partial hepatectomy in C57Bl mice was also apparently incapable of increasing the activity of this repair function. These experiments, in which repair of O6-methylguanine has been determined both in vivo after administration of [14C]DMN and in vitro using crude tissue extracts and a methylated DNA substrate, indicate the presence of an intergeneric difference between rats and mice with respect to this repair function.

Aflatoxin B1↗
PubMed2002

The beginnings of developmental biology in Swiss universities.

This contribution describes the pioneer work in Developmental Biology, initiated by Swiss scientists. The anatomist W. His (1831-1904) deserves credit as the founder of "Descriptive Embryology". Using novel microscopical techniques, he documented the formation of the embryonic body of various vertebrates as an approach to reveal the mechanisms of morphogenesis. Based on studies of the chick embryo, he designed a fate map of the germ-disk, comprising organ-forming regions, from which the corresponding embryonic structures originate. F. Baltzer (1886-1974) initiated original studies on the role of nuclear and cytoplasmic factors in the development of sea urchin hybrids and newt merogons. Through his experiments on interspecific and intergeneric chimeras of amphibians, he further contributed to the emerging field of "Developmental Genetics". F.E. Lehmann (1901-70) inaugurated work on "Chemical Embryology" and later moved to "Cell Biology". His discoveries on stage- and regional-specific inhibition of morphogenesis by LiCl in newt embryos were important for the understanding of malformations. Further studies regarding the action of cytostatic substances on tail regeneration in tadpoles were intended to yield information on growth control. Original contributions to "Experimental Embryology" were also made by R. Geigy (1902-1995), who devised an ingenuous procedure for obtaining sterile Drosophila flies by UV-irradiation of eggs. In later studies on anuran metamorphosis, he discovered that the morphogenetic effects of the metamorphic hormones are organ-specific and that competence of the larval tissues to respond to thyroid hormone is stage-dependent.

Developmental Biology↗
PubMed2002

Living arrangements of older adults in the developing world: an analysis of demographic and health survey household surveys.

OBJECTIVES: This study examines living arrangements of older adults across 43 developing countries and compares patterns by gender, world regions, and macro-level indicators of socioeconomic development. METHODS: Data are from Demographic and Health Surveys. The country is the unit of analysis. Indicators include household size, headship, relationship to head, and coresidence with spouse, children, and others. Unweighted regional averages and ordinary least-squares regressions determine whether variations exist. RESULTS: Average household sizes are large, but a substantially greater proportion of older adults live alone than do individuals in other age groups. Females are more likely than males to live alone and are less likely to live with a spouse or head of a household. Heading a household and living in a large household and with young children is more prevalent in Africa than elsewhere. Coresidence with adult children is most common in Asia and least in Africa. Coresidence is more frequent with sons than with daughters in both Asia and Africa, but not in Latin America. As a country's level of schooling rises, most living arrangement indicators change with families becoming more nuclear. Urbanization and gross national product have no significant effects. DISCUSSION: Although living arrangements differ across world regions and genders, within-region variations exist and are explained in part by associations between countrywide levels of education and household structure. These associations may be caused by a variety of intermediating factors, such as migration of children and preferences for privacy.

Adolescent↗
PubMed2006

An overview of ethnicity and assessment of family history in primary care settings.

PURPOSE: To discuss the importance of and the nurse practitioner's (NP's) role in the assessment of ethnicity/family of origin in conducting a multigenerational family history in primary care settings. DATA SOURCES: A review of the literature on past research results addressing racial and ethnic disparities and current articles from scientific journals exploring the relationship between race and genetics. Web sites were from the National Institutes of Health, the Human Genome Research Institute, the National Cancer Institute, and the Health and Human Services Minority Health and Disparities report. CONCLUSIONS: The family history has received renewed interest due to the sequencing of the human genome. A multigenerational family history is an important first step in screening for a multitude of disorders impacted by genetic susceptibility, shared environments, and common behaviors. Assessment of the patient's ethnicity/family of origin is an integral part of the multigenerational family history, particularly in the diagnosis of chronic diseases and the assessment of risks for genetic disorders. The multigenerational family history is important in diagnosis, predictive genetic testing, disease prevention, and health promotion. Challenges facing NPs and the utilization of a multigenerational family history in the current U.S. health system include (a) training clinicians on the correct assessment and utilization of a multigenerational family history, (b) assessment of the subtleties of ethnicity and identifying multiple ethnic groups within a family, (c) collection of the family history in a manner that is sensitive to the cultural beliefs of individuals, and (d) avoidance of stereotyping. IMPLICATIONS FOR PRACTICE: Significant advances in genetics and genetic testing requires that NPs be well versed in collecting and interpreting a multigenerational family history to include assessment of the patient/family's ethnicity/family of origin. The ability to effectively conduct and evaluate the individual's and family's health risk through a multigenerational family history will be important in diagnosis, health promotion, disease prevention, and the determination for genetic counseling referral and predictive testing when appropriate. Assessment of risk and prevention of disease is also important in reducing health disparities.

Attitude to Health↗
PubMed1995

Public pensions, family allowances and endogenous demographic change.

"A tax-transfer system deals with redistribution a PAYGmong generations and corrective taxation a PAYGt the same time. Since such a policy is a government's task, we take a normative approach and pose the question: Which tax-transfer system should a government apply to maximize social welfare? The framework we consider allows for endogenous demographic aspects...: first, fertility has a great impact on a PAYG [pay-as-you-go] financed pension insurance; and second, through education human capital is accumulated.... We analyzed the optimal extent of a public pension scheme in the presence of external effects of fertility and education on the net domestic product." Pension schemes in Germany and the United States are compared.

Aid to Families with Dependent Children↗
PubMed1997

Expanded CAG/CTG repeats in bipolar disorder: no correlation with phenotypic measures of illness severity.

The hypothesis that expanded trinucleotide repeats (TNRs) contribute to the pathogenesis of bipolar disorder has received strong support from recent studies showing that, on average, bipolar patients carry larger repeat sequences of the TNR motif CAG/CTG than do controls. It has been postulated that intergenerational expansion of a TNR may be responsible for the tendency for age of onset to become earlier in younger generations (anticipation) observed in some bipolar pedigrees, and that length polymorphism may account for variability in clinical phenotype. We have used the method of repeat expansion detection to examine these predictions in a sample of 133 Caucasian DSM-III-R bipolar I probands from the British Isles. We found no evidence to support the notion that CAG/CTG TNR genes are major determinants of phenotypic severity or age at onset in the population examined, and conclude that for most cases of bipolar disorder TNR genes may operate as susceptibility genes rather than as single genes of major effect.

Adult↗
PubMed1994

Telephone counseling interventions with caregivers of elders.

1. The use of the telephone in therapy has been documented in the care of disabled persons and persons with cancer and can be used with other populations. Telephone counseling is a feasible addition to the repertoire of assistance programs available. 2. The use of telephone counseling as an in-home intervention addresses some of the major limitations of out-of-home interventions, such as travel, making arrangements for an alternate caregiver, and worry due to absence from the care recipient. Telephone counseling also provides a means of reaching isolated or rural caregivers who have few or no available services. Telephone care can be a cost-effective, time efficient, and culturally acceptable intervention. 3. Telephone counseling has a potential value with caregivers comparable to the outcomes derived from pioneer mental health services, such as crisis intervention, suicide hot lines, and information and referral services. Nurses and other health care workers are encouraged to respond to the opportunities and challenges, as well as the promises, of telephone counseling intervention.

Activities of Daily Living↗
PubMed1999

Intrauterine growth restriction: a perspective for Pakistan.

BACKGROUND: Intrauterine growth restriction (IUGR) is the second leading contributor to the prevailing perinatal mortality and morbidity. It affects 23.8% of newborns around the world and 75% of these affected infants are born in Asia. In Pakistan the incidence of IUGR is around 25%, more than the WHO criteria for triggering a public health action. INTRODUCTION: IUGR is implicated with profound long-term impacts in adult life; like coronary heart disease, NIDDM and abnormal cortisol levels. The effects of the short and long term sequelae are reviewed. ETIOLOGY: IUGR is associated with a wide variety of etiological factors. But the factor unique in its importance to Pakistan is maternal malnutrition. The fetal gene expression is under the influence of nutrition. Growth projection curves showing the interaction between the genetic and environmental factors are discussed. SURVEILLANCE: Identification of IUGR baby in a primary care setting and the options in diagnosis in secondary and tertiary care settings are overviewed. CONCLUSION: The roots of this problem, with multi factorial causes are in the socioeconomic infrastructure. This calls for a synergistic approach of reducing this public health issue. Women empowerment can help us to get out of this intergenerational cycle of growth failure. Availability of resources aside, it is also a matter of political will to change things for the better.

Fetal Growth Retardation↗