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Predictors of children's postdivorce adjustment.

Six hypotheses to explain how divorce may affect the trajectory of child development were tested using standardized measures and sociodemographic data. Correlational and multiple regression analyses revealed that the parent adjustment hypothesis received the strongest support. Boys appeared sensitive to events and behavior in their mothers' lives, while girls seemed attuned to mothers' internal states.

Adaptation, Psychological↗

Predictors and correlates of adaptation to conjugal bereavement.

The authors interviewed 162 widows 1, 6, 12, and 24 months after bereavement to determine which sociodemographic, prebereavement, and response variables and circumstances of the husband's death were related to distress level, as measured by the General Health Questionnaire (GHQ). The most important variable associated with high distress at 1 month was the woman's perception that she was seeing old friends less than before her husband's death. At 2 years it was possible to predict distress levels with 86% accuracy by means of a multiple regression analysis using 10 variables, including 1-month GHQ score, short final illness of the husband, and satisfaction with available help.

Adaptation, Psychological↗

The sexual and reproductive behavior of American women, 1982-1988.

Comparison of 1988 data from the National Survey of Family Growth with 1982 data reveals that the proportion of U.S. women who have had sexual intercourse rose slightly, from 86 percent to 89 percent. Among teenagers, the proportion sexually active rose from 47 percent to 53 percent; most of the change is attributable to increases occurring among white and nonpoor teenagers, thus narrowing racial and income differences. Among women aged 15-44 in 1988 who have ever had intercourse, 67 percent reported that they had had two or more sexual partners in their lifetime. The proportion was highest among women aged 20-34 (about 70 percent), but 58 percent of sexually active teenage women reported having had two or more sexual partners. About 67 percent of women of reproductive age in 1988 were exposed to the risk of unintended pregnancy, up from 63 percent in 1982. Among these women, 35 percent rely on contraceptive sterilization to prevent pregnancy and 55 percent use reversible methods, while 10 percent use no method. Poor women are much more likely than nonpoor women to be using no method of contraception (15 vs. eight percent); among poor teenagers, this proportion reaches 25 percent. The level of contraceptive use at first intercourse among teenage women improved substantially between 1982 and 1988, however, rising from 48 percent to 65 percent. During 1984-1988, almost four in 10 births and almost six in 10 pregnancies among American women were unintended; most of these were mistimed, but 12 percent of births were unwanted ever.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Twinning rate in Scandinavia, Germany and The Netherlands during years of privation.

Twinning rates were studied in Swedes, Aland Islanders, Finns, Germans, and Dutch during years of starvation when death rates were two to three times higher than average. In contrast to the situation among some animals, this study suggests that nutrition above a certain threshold is unimportant for human reproduction, including twinning. The twinning rates for these different populations display marked temporal differences, but low values in the twinning rate are not consistently associated with periods of epidemics, famine, or similar nutritional stress. After years of privation and/or separation of spouses, a rapid "catch-up effect" can often be seen in the twinning rates, as well as marriage and birth rates. Psychoendocrine factors and interparental immunological conditions that may be involved in this phenomenon are discussed.

Female↗

Why women choose trial of labor or repeat cesarean section.

Despite growing interest in vaginal birth after previous delivery by cesarean section, virtually no studies have examined patient decision making in any depth. This paper examines the social content and cognitive structure of pregnant women's decisions to attempt delivery by trial of labor or for elective repeat cesarean section. Three features of childbirth care strategies are discussed. First, social goals are as central to women's decisions as are medical risks. Second, women reinforce their decisions by defining multiple benefits for the preferred alternative and multiple hazards for the rejected alternative. Third, women do not attempt to assess the probabilities of particular outcomes, but instead construct mental images of anticipated events based upon past childbirth experience and expected consequences of the preferred course of action.

California↗

Combining work and home.

The health consequences for women of combining work outside the home with domestic responsibilities are reviewed. The chapter evaluates role stress as a function of multiple roles and concludes that such juggling promotes women's health by offering increased variety of functions performed as well as increased emotional buffering. The chapter also concludes that women's working outside the home has a positive effect likewise on children and spouses.

Female↗

[Studies on the influencing factors of the infertility rate in the rural area of Jiangsu Province].

This paper analyzed the influencing factors of the infertility rate in the rural area of Jiangsu province by means of chi 2 test and multiple regression model. The overall infertility rate was 5%. The results showed that the infertility rate was higher in older women, smokers, couples in the lower socioeconomic groups, much early or later married women. It is worth mentioning that the effect of variables affecting the fertility rate was difference between Southern Jiangsu area and Northern area. Women's habits of smoking and education level have a greater effect on the infertility rate in Southern Jiangsu area, whereas economic condition and women's marriage play a more prominent role in the North.

China↗

Pulmonary agenesis as part of the VACTERL sequence.

Pulmonary agenesis is an uncommon anomaly that has been reported in isolation and in association with other congenital defects. Such defects include oesophageal atresia, cardiac malformation, horseshoe kidney, and anal atresia. Over a period of three years we have seen five neonates or fetuses with unilateral agenesis of the lung. All the cases had three or more anomalies seen in the VACTERL sequence in addition to the pulmonary atresia. None had a tracheo-oesophageal fistula. None were the products of consanguineous marriages. There had been no recurrence of this range of defects in any of the families at the time of writing. We suggest that pulmonary agenesis may occur as an alternative to tracheo-oesophageal fistula in the VACTERL sequence.

Abnormalities, Multiple↗

Three sibs with phalangeal anomalies, microcephaly, severe mental retardation, and neurological abnormalities.

This paper describes three children of a Pakistani first cousin marriage with a distinctive, non-progressive disorder characterised by variable phalangeal anomalies, microcephaly, pre- and postnatal growth retardation, poor vision, dystonic movements, a characteristic face, and severe mental retardation. This combination of features seems to be distinct and to represent a new autosomal recessive syndrome.

Abnormalities, Multiple↗

AIDS-related secular trends in cancer in Los Angeles County men: a comparison by marital status.

Data from the population-based cancer registry for Los Angeles County, an area with high risk of AIDS, were used to evaluate secular trends of Kaposi's sarcoma (KS), non-Hodgkin's lymphoma, and other possibly AIDS-related cancers in men aged 18 to 54. Marital status was used as a surrogate for homosexual behavior to compare the proportional incidence rates for the pre-AIDS era, 1972 to 1979, to those for 1980 to 1982 and 1983 to 1985. Both absolute incidence and proportional incidence of KS continue to increase sharply, although in absolute numbers, KS is making a smaller contribution to the total number of AIDS cases as the Los Angeles County epidemic progresses. For never-married men the proportional incidence rate of KS in 1983 to 1985 was nearly 100-fold greater than that of 1972 to 1979 and 7-fold greater than that of 1980 to 1982. High-grade lymphomas show statistically significant secular increases in both never-married and ever-married men, but only the rates of Burkitt's lymphomas have increased to a greater extent in never-married men. A small but significant increase of central nervous system lymphomas is seen in both marital status groups. There is no evidence of any AIDS-related increases in Hodgkin's disease, leukemia, testicular cancer, anal cancer, liver cancer, oral cancer, multiple myeloma, or malignant melanoma. As of 1985, cancer, as a manifestation of AIDS, is still apparently limited to KS and high-grade lymphomas (particularly Burkitt's) in Los Angeles County.

Acquired Immunodeficiency Syndrome↗

Path analysis under generalized marital resemblance: evaluation of the assumptions underlying the mixed homogamy model by the Monte Carlo method.

Path analysis of nuclear family data has been widely applied to resolve genetic and environmental sources of familial resemblance. Here we report the results of a systematic evaluation of the effects of departures from five modeling assumptions often made when analyzing nuclear family data; i) the observed environmental index is unaffected by the genotype, ii) the basis of marital resemblance is correctly specified in the model, iii) there are no intergenerational differences in either the genetic or cultural heritability, iv) there is no genetic dominance, and v) there is no genotype by family environment interaction. "Deterministic simulations" identified various situations where model misspecification could lead to substantial bias in the estimation of the heritabilities. For these situations, "stochastic simulations" were performed to determine whether the "goodness-of-fit" test used in path analysis would correctly reject the misspecified model. In samples of 500 nuclear families, each comprising two parents and two children, the goodness-of-fit test was found to be sensitive to misspecifications of the source of marital resemblance and the existence of intergenerational differences in heritabilities, although reduced power would make the test less sensitive in smaller samples. The test was largely insensitive to misspecifications of possible genetic effects on the environmental index, and to the existence of multiplicative interaction between the genotype and familial environment. When genetic effects on the index are ignored, the genetic heritability (h2) is underestimated, the cultural heritability (c2) is overestimated, but h2+c2 remains unchanged. Neglecting the interaction was found to result in an overestimate of h2.

Consanguinity↗

Men's extramarital sex, marital relationships and sexual risk in urban poor communities in India.

The objectives of this paper are to (1) understand the nature of men's extramarital sexuality in three low income communities in Mumbai, India; (2) explore the associations between marital relationships and extramarital sex; and (3) assess the implications of the research results for intervention. Results are based on survey data collected from 2,408 randomly selected men from the three study communities and a matched subset of 260 randomly selected men and their wives who responded to a female version of the men's survey. These surveys produced a unique data set, which allows sociodemographic, attitudinal and behavioral variables from husband and wife and variables that are the product of husband and wife interaction to be utilized to predict men's extramarital sex through multiple sequential logistic regression analysis. Results indicate that men's extramarital sex is significantly associated with husband's and wife's age, wife's perception of domestic violence, husband's education and place of birth, husband's alcohol use, wife's willingness to engage in marital sex, and types of marital sexual acts. These results confirm the need to move from the individual to the couple as the unit of research and the need for intervention to reduce the risk of HIV/STI transmission within marriage both in India and internationally.

Adult↗

Contribution of BRCA1 and BRCA2 mutations to breast and ovarian cancer in Pakistan.

The population of Pakistan has been reported to have the highest rate of breast cancer of any Asian population (excluding Jews in Israel) and one of the highest rates of ovarian cancer worldwide. To explore the contribution that genetic factors make to these high rates, we have conducted a case-control study of 341 case subjects with breast cancer, 120 case subjects with ovarian cancer, and 200 female control subjects from two major cities of Pakistan (Karachi and Lahore). The prevalence of BRCA1 or BRCA2 mutations among case subjects with breast cancer was 6.7% (95% confidence interval [CI] 4.1%-9.4%), and that among case subjects with ovarian cancer was 15.8% (95% CI 9.2%-22.4%). Mutations of the BRCA1 gene accounted for 84% of the mutations among case subjects with ovarian cancer and 65% of mutations among case subjects with breast cancer. The majority of detected mutations are unique to Pakistan. Five BRCA1 mutations (2080insA, 3889delAG, 4184del4, 4284delAG, and IVS14-1A-->G) and one BRCA2 mutation (3337C-->T) were found in multiple case subjects and represent candidate founder mutations. The penetrance of deleterious mutations in BRCA1 and BRCA2 is comparable to that of Western populations. The cumulative risk of cancer to age 85 years in female first-degree relatives of BRCA1-mutation-positive case subjects was 48% and was 37% for first-degree relatives of the BRCA2-mutation-positive case subjects. A higher proportion of case subjects with breast cancer than of control subjects were the progeny of first-cousin marriages (odds ratio [OR] 2.1; 95% CI 1.4-3.3; P=.001). The effects of consanguinity were significant for case subjects with early-onset breast cancer (age <40 years) (OR=2.7; 95% CI 1.5-4.9; P=.0008) and case subjects with ovarian cancer (OR=2.4; 95% CI 1.4-4.2; P=.002). These results suggest that recessively inherited genes may contribute to breast and ovarian cancer risk in Pakistan.

Adult↗

A survey of public awareness, understanding, and attitudes toward epilepsy in Greece.

PURPOSE: To assess familiarity, understanding, and attitude toward epilepsy in Greece and identification of negative predictive factors. METHODS: A 19-item questionnaire was administered to 750 adults. The magnitude of social stigma toward epileptic people with epilepsy was measured with a quantitative scale of social rejection. Statistical analysis with chi-square and multiple regression analysis were used to identify factors associated with negative attitudes. RESULTS: Of our respondents 38.8% knew someone with epilepsy and 50.8% had witnessed a seizure. Nineteen percent believed that epilepsy is a type of mental retardation, 15% believed it is a type of insanity, 91.8% considered epilepsy as a brain disorder while 5.2% considered it as a supernatural phenomenon. Seventy-seven percent considered epilepsy as a curable disease while 57.5% believed that the risk of inheriting it is very high. Regarding marriage to a patient with epilepsy 45.4% rejected it while regarding his employment 37.7% were positive, 47.8% were skeptical while 12.8% were against it. The Greek public's rejection tendency toward epileptic people was generally low. Negative predictive factors were older age, low educational level, unfamiliarity with epilepsy, and erroneous beliefs about epilepsy. CONCLUSIONS: The Greek public is familiar with epilepsy but has a suboptimal level of appropriate understanding of essential aspects of the disease. The overall public's level of rejection toward people with epilepsy is low but certain groups of people are highly rejective. Information campaigns targeting specific population subgroups are necessary in Greece in order to improve the public's understanding of epilepsy and tolerance toward people with epilepsy.

Adolescent↗

An electric wheelchair mounted robotic arm--a survey of potential users.

This paper describes the results of a survey which investigated and evaluated the needs and abilities of electric wheelchair users. The results of this survey will be used to develop a low-cost electric wheelchair-mounted robotic arm for use by physically disabled people to facilitate rehabilitation. The survey was undertaken by the author together with staff and students from occupational therapist training colleges, using a four-page questionnaire containing over 110 questions. The questionnaire was developed by the author together with Dr Robin Platts (Director of Orthotics), Mr Ian Bayley (Director of the London Spinal Unit) and senior occupational therapists at the Royal National Orthopaedic Hospital, Stanmore, Middlesex. After a successful trial the questionnaire was used with 50 severely disabled people from various backgrounds and social circumstances. The results of this survey show that the average electric wheelchair user is 40 years old, single (68%), living at home (58%) with family support (69%) and without any paid employment (79%). The most prevalent disability is spinal cord injury (24%) followed by multiple sclerosis (16%). The survey has identified several tasks which electric wheelchair users find impossible to do, and some of these will form part of the design specification. Finally 84% of the survey subjects would consider buying such a robotic aid.

Activities of Daily Living↗

Biologic and psychosocial risk factors of sudden death from coronary disease in white women.

The relation of the risk of sudden death from arteriosclerotic heart disease to psychosocial and biologic factors was studied retrospectively in 64 white women who died suddenly of arteriosclerotic heart disease and in 64 age-related neighborhood control women. All sudden deaths occurred outside the hospital within 24 hours of the onset of symptoms in women who were not incapacitated before death. Women who died suddenly were less often married, exhibited more educational incongruity with their spouses and had fewer children than the control population. Twelve of the 64 women who died suddenly of heart disease and none of the control women had a definite history of psychiatric treatment. The women who died suddenly also smoked more cigarette and consumed greater quantities of alcoholic beverages than age-matched neighborhood control women. Multiple regression analysis revealed that history of psychiatric illness, cigarette smoking, alcohol consumption, educational incongruity and number of children contributed significantly to differences between women who died suddenly of heart disease and control subjects.

Adult↗

Immigrant fertility: an examination of social characteristics and assimilation.

"This study compares the fertility patterns of foreign-born and native-born women in Canada and examines whether [the] same set of social characteristics accounts for differential fertility among both the groups. The study also assesses the importance of social characteristics and assimilation on immigrant fertility behavior. Two generations of currently married/cohabiting women with spouse present are analyzed using multiple regressions. The results reveal similar effects on fertility of social characteristics for foreign-born and native-born, while in the case of younger generations the effects are stronger."

Acculturation↗