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PubMed1977

[Genetic counselling (results of ten years experience). II. Requests (author's transl)].

The authors give a summing up of ten years of genetic counselling concerning 1271 requests and single out two equally important categories of consultants. The first might require premarital counselling (in cases of consanguineous unions, or when one of the partners or relatives are affected) but, in fact, come to consultation, four times out of ten, after marriage and even after procreation. The consultants of the second group need prenatal counselling either because a child suffers from a hereditary disorder, or because earlier pregnancies did not come to term. Whichever the type, one consultation out of seven concerned a pregnant woman. A classification by type disorder and by mode of transmission is given.

Abnormalities, Multiple↗
PubMed1996

Life domains, alcoholics anonymous, and role incumbency in the 3-year course of problem drinking.

This study examined the course of problem drinking among 439 individuals over 3 years, using a life domains perspective that distinguishes life stressors and social resources in different contexts. More severe chronic financial stressors both predicted and were predicted by more alcohol consumption and drinking-related problems. Among social resources, Alcoholics Anonymous was the most robust predictor of better functioning on multiple outcome criteria. Support from friends and extended family also predicted better outcomes; this effect was stronger for individuals who were low on primary role incumbency (i.e., who were unemployed and/or did not have a spouse/partner).

Adaptation, Psychological↗
PubMed1998

Study of Down syndrome in 238,942 consecutive births.

The genetics and the epidemiology of Down syndrome (DS) was studied in the area which is covered by our registry of congenital malformations. For each of the 398 new DS cases which were ascertained during the period 1979 to 1996 more than 50 factors were studied and compared to those from control infants. The prevalence of DS was 1.66 per 1000; 2.2% of the DS cases were stillbirths and 29.4% were induced abortions. Karyotypes were obtained in 391 cases of which all but 23 were 47,+21;9 were mosaics (2.3%), and 14 had translocations (3.6%). Interchromosomal effect was a question in 7 cases. The most common types of associated malformations were cardiac anomalies (46.2%) and intestinal atresias (6.0%). Seasonality or time/space clusters were not observed in spite of the Chernobyl nuclear accident. No paternal age effect was demonstrated; 5.3% of the mothers of DS had 2 previous spontaneous abortions (controls 3.7% p < 0.05). At birth, the DS infants measured and weighted less and their head circumference was lower than in control infants. Weight of placenta was also lower than in control infants. In this material there were 4.5% of consanguineous marriages (P < 0.01). The pregnancies of the DS children were more often complicated by threatened abortions than in the controls, 3.2% of the mothers of the DS children were diabetic controls (1.7%), although the difference was not statistically significant. For all other factors studied no statistically significant difference with respect to controls could be demonstrated.

Abnormalities, Multiple↗
PubMed1977

The multiple techniques approach to behavioural psychotherapy: a retrospective evaluation of effectiveness and an examination of prognostic indicators.

A retrospective evaluation of the multiple techniques approach to behaviour therapy is described. The effectiveness of the approach seems to compare favourably with a single-technique approach as far as can be ascertained. The observed improvement can be attributed to some aspect of the treatment package and not to 'spontaneous remission' factors. A prospective trial would not seem valuable, providing the problems of replication can be solved. An examination of prognostic indicators reveals a range of variables associated with outcome. Amongst the diagnostic groups, the 'social phobics' and 'anxiety states' did poorly. A number of general adjustment variables also seemed important, particularly marriage, and social and vocational adjustment. The implications of these findings for the nature and deployment of services and briefly discussed.

Adult↗
PubMed2000

Disease prevalence in women attending the STD clinic in Mumbai (formerly Bombay), India.

Our objectives were to determine the prevalence of Neisseria gonorrhoeae and its association with other STD causing organisms. Three hundred and thirty-six consecutive women (female sex workers (FSWs) and married contacts), attending a sexually transmitted disease (STD) clinic in Mumbai, were screened for N. gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis. Per speculum examination was performed and clinical signs were recorded. Symptoms perceived by the women were also recorded. The mean age for married contacts, FSWs and gonorrhoea-positive women was 27.9, 29.7 and 27.5, respectively. 9.7% of the women were positive for N. gonorrhoeae, 23.2% were chlamydia-positive and 5.9% had trichomoniasis. N. gonorrhoeae was isolated more frequently from FSWs as compared to the married contacts. The prevalence of HIV was significantly higher among women with multiple sex partners (FSWs) (P<0.001). Gonococcal infection is significantly associated with the presence of HIV. A significant association between sexual habits and prevalence of gonorrhoea, trichomoniasis and HIV was observed. The prevalence of gonorrhoea over 1988 to 1996 remained approximately the same.

Adult↗
PubMed1993

Identification of psychobiological stressors among HIV-positive women. HIV Neurobehavioral Research Center (HNRC) Group.

This research describes major stressors in the lives of women who have been infected with the human immunodeficiency virus (HIV). Thirty-one HIV antibody positive (HIV+) women infected primarily through heterosexual contact participated in a two hour semi-structured interview detailing the circumstances, context, and consequences of all stressful life events and difficulties experienced within the preceding six months. Qualitative methods of data analyses were utilized (Miles & Huberman, 1984). HIV-related life events and difficulties were classified into primary and secondary stressors based on the stress process model (Pearlin et al., 1981). Problems arising directly from one's seropositivity were defined as primary stressors. Stressful life events and difficulties occurring in other role areas were defined as secondary stressors. Six categories of HIV-related stressors were identified and quantified. Primary stressors were health-related, and included both gynecological problems (e.g., amenorrhea) and general symptoms of HIV infection (e.g., fatigue). Secondary stressors related to child and family (e.g., future guardianship of children), marital/partner relations (e.g., disclosure of HIV+ status), occupation (e.g., arranging time-off for medical appointments), economic problems (e.g., insurance "hassles"), and social network events (e.g., death of friends from AIDS). This research indicates that HIV-positive women are exposed to multiple stressors; some may be viewed as unique to women, whereas others may be considered common to both sexes. Identification of stressors has implications for the design of medical and psychiatric interventions for women.

Adult↗
PubMed1997

Characteristics of dual diagnosis patients admitted to an urban, public psychiatric hospital: an examination of individual, social, and community domains.

The study provides descriptive data on a large, diverse sample of dually diagnosed patients from an urban psychiatric inpatient setting, utilizing a comprehensive array of clinical, social and community functioning measures. The intent is to provide more useful and reliable information, particularly concerning African-Americans with a dual diagnosis in the public sector. Over a one year period, all persons admitted to a public psychiatric hospital with a DSM-III-R psychiatric diagnosis and a positive screen for substance abuse problems using clinical and structured measures (n = 486) were interviewed on the Addiction Severity Index (ASI) and other measures to assess community and social functioning, alcohol and drug use, psychiatric problems, and service histories. The majority of participants were found to have serious economic and employment problems, undesirable living arrangements, limited or conflictive family or social relationships, and some record of arrest. The ASI problem areas most to least in need of treatment were: psychiatric, alcohol and drug abuse, employment, family/social, legal, and medical. Substances most often currently abused were alcohol, cocaine, and cannabis; there was a high rate of polydrug abuse. Participants had experienced a median of 3.0 previous psychiatric hospitalizations, fewer outpatient substance abuse treatments, and limited community mental health contact. Some subgroup differences based on gender, age, and race were found which have implications for community treatment planning. The study results document the extreme heterogeneity in the dually diagnosed as well as their multiple treatment needs. To better inform treatment planning, future research on dual diagnosis should attempt to establish meaningful subgroups relevant to service needs and should utilize diverse clinical and functioning measures.

Adult↗
PubMed2005

Quality of life and its determinants of hemodialysis patients in Taiwan measured with WHOQOL-BREF(TW).

BACKGROUND: In 1991, the World Health Organization (WHO) initiated a cross-cultural project to develop a quality-of-life (QOL) questionnaire (WHOQOL); soon after this, the clinically applicable short form was developed and named WHOQOL-BREF, followed by a Taiwanese version (WHOQOL-BREF[TW]). METHODS: We first administered the WHOQOL-BREF(TW) and symptom/problem scale to 376 patients with end-stage renal disease on regular hemodialysis therapy in Taiwan. Analysis with multiple stepwise regressions was conducted to study determinants of QOL domains and items. RESULTS: The WHOQOL-BREF(TW) was reliable and valid from various validation studies. The 4 domains (physical, psychological, social relations, and environment) and global items (overall quality of life and general health) of the WHOQOL-BREF(TW) each differentiated symptoms/problems of hemodialysis patients from age-, sex-, and education-matched healthy referents. The 4 domains, except for environment and global items of the WHOQOL-BREF(TW), each differentiated erythropoietin dosage from age-, sex-, and education-matched healthy referents. After adjusting for age, sex, marriage, and education, the prominent associated factors of various QOL domains and items were age, area (Taipei or Keelung), hemoglobin level, normalized protein catabolic rate, and symptom/problem scale. CONCLUSION: The WHOQOL-BREF(TW) is reliable and valid for long-term study of hemodialysis patients, and hemodialysis had negative impacts on QOL, especially in patients with more severe disease with greater symptom/problem scores, lower hemoglobin levels, and lower normalized protein catabolic rates.

Adult↗
PubMed2006

Parenteral transmission during excision and treatment of tuberculosis and trypanosomiasis may be responsible for the HIV-2 epidemic in Guinea-Bissau.

BACKGROUND AND OBJECTIVE: The factors that led to the simultaneous emergence, decades ago, of HIV-1 in central Africa and HIV-2 in West Africa remain unclear. The low HIV-2-associated mortality enables epidemiological assessment of risk factors potentially relevant in the early stages of the epidemic. In Guinea-Bissau, its epicentre, HIV-2 became highly prevalent (approximately 15%) in cohorts of individuals born before 1962, but is now disappearing whereas HIV-1 prevalence is increasing. We sought to verify the hypothesis that parenteral transmission was the key factor in the building-up of the HIV-2 epidemic. DESIGN: Cross-sectional community survey of 1608 individuals aged > or = 50 years in Bissau. METHODS: Capillary blood was obtained for HIV serology. Associations between HIV-2 (alone or in dual HIV-1/HIV-2 infections) and exposures were measured with crude and adjusted odds ratios (AOR) and 95% confidence intervals (CI). RESULTS: Prevalence of HIV-2 was higher in women (160/1063; 15.1%) than men (45/545; 8.3%, P < 0.001). Among women, excision (AOR, 1.54; 95% CI, 1.08-2.18) was independently associated with HIV-2, as were age and being widowed (AOR, 1.88; 95% CI, 1.29-2.74). Among men, HIV-2 was not associated with sexually transmitted infections or transactional sex. In an analysis comprising men and women that was adjusted for age, sex, ethnic group and marital status, HIV-2 was associated with having received injections for the treatment of tuberculosis (AOR, 2.12; 95% CI, 1.11-4.05) or trypanosomiasis (AOR, 1.75; 95% CI, 1.03-2.97). CONCLUSIONS: Parenteral transmission through ritual excision and multiple injections during treatment of tuberculosis and trypanosomiasis contributed to the emergence of HIV-2 in Guinea-Bissau.

Adolescent↗
PubMed1990

Racial and ethnic differences in U.S. census omission rates.

This article assesses differences in rates of omission across seven race-ethnicity groups in the 1980 census to learn more about the social factors that condition census enumeration. Findings indicate that there are multiple sources of error, that these sources reflect distinctive ethnic attributes to a greater degree than shared minority status, and that census omissions have both inadvertent and motivational causes. The discussion notes some of the implications for improving coverage in future censuses.

Adolescent↗
PubMedDate not supplied

Relationship of psychosocial and perinatal variables to perception of childbirth.

This study reported on a sample of 294 first-time mothers. Fifty-six women who delivered by cesarean birth perceived their childbirth experience more negatively than those who delivered vaginally. However, the type of delivery accounted for only 1% of the variance when entered with 24 other psychosocial and obstetrical variables for stepwise multiple regression analysis. Mate emotional support contributed 20% and early maternal-infant interaction contributed 9.8% of the variance, with total positive self-concept, fewer medical complications, informative support, instrumental support, and type of delivery accounting for the remainder of the total 39%.

Adolescent↗
PubMed1986

[The contribution of alcohol to nutrition: addition or substitution according to cultural origins].

The relation of alcohol intake to diet is analyzed through multiple linear regression for a sample of 475 males living in Geneva. Control variables are age, relative weight index, marital status and employment status. Whereas alcohol is associated with higher dietary intake for people of mediterranean origin, it tends to replace food calories for natives of german speaking areas.

Age Factors↗
PubMed2005

Towards a family process model of maternal and paternal depressive symptoms: exploring multiple relations with child and family functioning.

BACKGROUND: Research has focused on maternal dysphoria and child adjustment. However, family process models indicate gaps in the study of paternal dysphoria, broader family functioning, and diverse child outcomes. METHOD: A community sample of 235 mothers and fathers of kindergarten children completed measures of depressive symptoms, family functioning and child adjustment. Teachers also provided measures of child adjustment. RESULTS: Supportive of pervasive effects even in a community sample, increased parental depressive symptomatology was related to increased marital conflict, insecure marital attachment, less parental warmth, more psychological control in parenting, and multiple child problems. Child gender moderated child outcomes differently for paternal and maternal dysphoria. Marital relations, but not parenting, mediated child outcomes. CONCLUSIONS: Marital problems may be especially reactive to parental depressive symptomatology, so that mediational processes affecting child functioning become evident even in family contexts of relatively low risk.

Child↗
PubMed1995

Epidemiologic features of Wilms tumor.

The elucidation of factors involved in the development of Wilms tumor represents a remarkable and fruitful marriage between epidemiology, clinical practice, histopathology, and molecular biology. Many fascinating research problems remain to be solved, and it is to be expected that the study of Wilms tumor will continue to yield valuable insights, not only in relation to Wilms tumor itself but also into tissue development and processes involved in malignant transformation in general.

Female↗
PubMed1989

Lethal form of fibuloulnar A/hypoplasia with renal abnormalities.

The present report describes two sibs with lethal acrorenal developmental complex who were products of a nonconsanguinous marriage. Clinical and roentgenologic characteristics did not match any of the known types of fibuloulnar dysostosis. Distinct abnormalities included lethality at birth, facial anomalies, ear anomalies, symmetrical mesomelic shortness of long bones, fibular agenesis, normal vertebrae, oligosyndactyly of phalanges, congenital heart defect, and cystic or hypoplastic kidney. These cases suggest a new lethal form of recessively inherited fibuloulnar dysostosis with renal anomalies.

Abnormalities, Multiple↗
PubMed1989

Mental distress and social conditions and lifestyle in northern Norway.

In a cross sectional survey of risk factors for coronary heart disease three questions about mental distress were included in a questionnaire completed by 13,704 people, 64% of the total population aged 20-54 in one municipality. Overall, 860 (12.5%) of the men and 1141 (16.8%) of the women reported having at least one symptom of mental distress. There were no distinct differences between the age groups. Single people, separated and divorced people, and those who reported that the financial situation of the family during their childhood was difficult reported more mental problems. Heavy smoking, frequent alcohol consumption, and, in men, little or no physical activity in leisure time were also associated with a high prevalence of mental distress. By multiple regression analyses, marital state, financial situation of family during childhood, and current lifestyle were found to be highly significantly associated with mental distress. Including a few questions on mental distress in health surveys provides a way to establish relations between such symptoms and social conditions and lifestyle in large numbers of subjects.

Adult↗
PubMedDate not supplied

Repeat pregnancy among adolescent mothers: a review of the literature.

Repeat pregnancy among adolescent mothers is a major problem facing healthcare providers today. Adolescents who experience multiple pregnancies often are subjected to overwhelming physical, social, economic, and psychological outcomes. Research is needed to investigate the problem of repeat pregnancy and provide empirical support for intervention programs developed to reduce the incidence. This paper is a review of previous research. Major factors related to repeat pregnancy are examined. In addition, recommendations for future research are discussed.

Adolescent↗
PubMed2006

Dilemmas of talking about lifestyle changes among couples coping with a cardiac event.

Persons who have experienced a myocardial infarction (MI) and/or coronary artery bypass graft (CABG) surgery may benefit from a low-fat diet, regular exercise, smoking cessation, and stress management. Yet many patients do not make these changes. A spouse or partner's attempts at support may facilitate or interfere with patient behavior change. The present study explores dilemmas that may arise when couples talk about lifestyle changes following one person's MI or CABG. In interviews carried out in Urbana-Champaign, Illinois, and surrounding communities with 25 patients and 16 partners we found communicating support for lifestyle change may be interpreted as undesired control or criticism. The caring conveyed by talking may be viewed positively but can also threaten patient autonomy and entrap partners in unwanted expectations and obligations. Finally, lifestyle change conversations may reflect empowered patients collaborating with partners to take control of health but can also serve as potent reminders of loss. These multiple, potentially conflicting meanings give an account for why talking with a partner does not always facilitate patient lifestyle change. Understanding these dilemmas also suggests practical implications for helping patients and partners.

Adaptation, Psychological↗