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PubMed1994

Determinants of racial fertility differentials in some urban areas of South Africa.

Results of a survey of some urban areas in the Pretoria-Witwatersrand-Vereenining region show differential impacts of proximate and socioeconomic factors on the fertility of urban blacks and whites. Timing of starting and ending of childbearing and the reproductive behaviour of women who have never been married account for the major differences in fertility levels. White women confine their childbearing career to the 20-39 age range, while black women utilise the entire 15-49 age range. The fertility level is quite high among black women who have never been married (in contrast to never married white women). With the exception of breast-feeding, racial patterns in other proximate determinants of fertility do not suggest the observed racial differentials in fertility.

Adolescent↗
PubMed1990

Personality correlates of marital dissatisfaction: a comparison of psychiatric, maritally distressed, and nonclinic samples.

This study examined the relationship between personality functioning as assessed by the Minnesota Multiphasic Personality Inventory (MMPI) and individuals' reports of marital distress on the Marital Satisfaction Inventory (MSI). Both the MMPI and MSI were administered to a total sample of 90 couples with 30 couples from each of three sources: couples in marital therapy, couples in which one partner was psychiatrically hospitalized or in individual outpatient psychotherapy, and nonclinic couples from the general population. Replicated scale-by-scale correlations between the two instruments generally indicated a positive but modest association between individuals' scores on the MMPI and self-reported marital distress. Both bivariate and multiple regression analyses employing either individual scales or conjoint configural analyses of couples' MMPI profiles consistently identified scale 4, Psychopathic deviance (Pd), as the best predictor of relationship distress across a broad spectrum of marital functioning. However, both individual MMPI scales and complex configural approaches misclassified a large percentage of couples across all three samples. Clinical implications of results are discussed.

Adult↗
PubMed2005

Crisis management during "live" supervision: clinical and instructional matters.

In this article, we illustrate two examples of "live" supervision with marriage and family therapy trainees whose clients presented in the therapy room in immediate crisis. The case examples, one a client with suicidal thoughts and the other a parent who had struck her child, demonstrate how the university-based therapy team managed the recursive clinical and supervision processes that unfolded during the sessions. We present the case examples from the perspective of both supervisees and supervisor, discussing how our different experiences of the supervision unfolded in real time. Case discussion and reflections later in the article illustrate the need for an open, transparent, dialogical process throughout supervision. A case is made for supervisory participants to create alternative formats in which multiple supervisory voices can be heard.

Adult↗
PubMed2001

The impact of marital status on cancer survival.

Marital differentials in survival from 12 common types of cancer are assessed by estimating a mixed additive multiplicative hazard regression model on the basis of individual register and census data for the whole Norwegian population. These data cover the period 1960-91 and include more than 100,000 cancer deaths. The data and method make it possible to take into account the marital mortality differentialsin the absence of cancer. The excess all-cause mortality among cancer patients compared with similar persons without a cancer diagnosis is, on the whole, more than 15% higher for never-married men, never-married women and divorced men, than for the married of the same sex. Other previously married have an excess mortality elevated by about 7%. This protective effect of marriage is not due to stage, which is controlled for. The possible importance of treatment and host factors is discussed.

Aged↗
PubMed1983

Engaged members of the Unification Church. Impact of a charismatic large group on adaptation and behavior.

This project was designed to study the psychological nature of compliance with unusual behavioral norms among members of a charismatic religious sect. Three hundred twenty-one members of the Unification Church had been placed into marital engagement a year previously in a highly unusual fashion: their partners were assigned to them by the group's leader as part of a religious ritual. The abrogation of contemporary norms for mate selection was not associated with increased psychological distress. Church-related life experiences, however, were perceived as being of considerable psychological impact. Multiple regression analyses further revealed that the vulnerability of respondents to perceived life disruption was relived by their affiliation to the sect. This "relief effect," associated with social and religious ties to the sect, apparently reinforces compliance with the group's behavorial norms, particularly since the manner of reinforcement is integrated into the social structure of the group.

Adaptation, Psychological↗
PubMed1999

Partners' ratings of combat veterans' PTSD symptomatology.

The current study examined the concordance of combat veterans' scores on the Mississippi Scale for Combat-Related PTSD, with scores on a parallel version of that instrument completed by partners to assess veterans' symptoms. Further, the study examined the impact of quality of the marital relationship on score concordance. Bivariate and multiple regression were used with a sample of 466 veteran-partner dyads obtained from the National Vietnam Veterans Readjustment Study. There was moderate agreement in symptom reporting between veterans and their partners and little evidence to suggest that the quality of the relationship impacted upon the association between partner and veteran scores.

Combat Disorders↗
PubMed1997

Interpersonal communication and sexual adjustment: the roles of understanding and agreement.

The influence of interpersonal communication on sexual adjustment in cohabiting heterosexual couples was investigated. Male and female partners from 76 heterosexual couples independently completed measures of their own and their partners' sexual preferences, as well as measures of sexual and general relationship adjustment, sexual difficulties, marital role preferences, depression, and social desirability. Results indicated that sexual satisfaction in both partners was associated with men's understanding of their partner's preferences and agreement between their preferences. The influential role of men's understanding was supported by hierarchical regression, convergent and discriminant evidence, and multiple regression models that accounted for 51% and 63% of variance in men's and women's sexual satisfaction. General relationship adjustment of both partners was associated with women's understanding of men's marital role preferences. An explanation of understanding's function is proposed, accounting for gender differences within and across sexual and general realms of relating.

Adaptation, Psychological↗
PubMed1998

Affect and marital adjustment in women's rating of dyspareunic pain.

OBJECTIVE: To investigate the extent to which depressive symptomatology, anxiety, and marital adjustment mediate pain ratings in women suffering from dyspareunia. METHOD: Seventy-six women with dyspareunia were administered the depression and anxiety scales of Derogatis's Brief Symptom Inventory and the McGill Pain Questionnaire. They also underwent a manual-visual gynecological examination, an ultrasound, and a colposcopy in an attempt to identify potential evidence and type of organicity. RESULTS: Depressive symptomatology, anxiety, and marital adjustment together accounted for a significant amount of the variance in pain ratings, although only anxiety and marital adjustment were independent predictors of pain ratings in the entire group of women with dyspareunia. When multiple regression analyses were then applied to different diagnostic subgroups of dyspareunia, the independent predictors of pain rating varied depending on the findings from the gynecological examinations. CONCLUSION: Affect and marital adjustment appear to be significant predictors of dyspareunic pain rating, although the independent contribution of psychosocial variables may vary depending on the presence and type of organic findings.

Adaptation, Psychological↗
PubMed1983

Epidemiology and genetics of endemic goiter. I. Epidemiological aspects.

This study dealt with approximately 2,000 children and their parents living in a hyperendemic goiter area in Central Brazil, which is bounded by the jungle to the north and by a large plain to the south. The determination of goiter was made according to the methods and classification adopted by WHO. Conspicuous forms of goiter were found in 41% of the children examined. Multiple linear regression analysis showed an increase with age in the frequency of goiter in both sexes. Although data from the literature show that Mulattoes and Negroes have statistically higher frequencies of goiter than do Whites, our multiple linear regression analysis revealed no evidence for an effect of race on the endemism. There was no significant association with socioeconomic level. The presence of goiter in parents was shown to be statistically associated with its occurrence in the children.

Adolescent↗
PubMed1975

[Pregnancy in spite of multiple factors of infertility in both marital partners (Author's transl)].

Case report of two deliveries in a woman with an oligospermic husband who had a laparoscopic coagulation of the uterosacral ligament for endometriosis, followed by ulilateral salpingectomy and partial resection of the other tube for bilateral pyosalpinx. The tubal stump was stitched into the ovary. The case is reported to demonstrate that it is worthwhile to retain a minimun of chance for conception even in a case with a very bad prognosis.

Adnexal Diseases↗
PubMed1983

[The demographic backdrop of families and children in Québec.].

This article presents the demographic background underlying the family evolution from the beginning of the XXth Century up to now. The first section describes the transformations of individual behaviour related to the family formation and stability. The main facts are the following : after a long period where a "legal" marriage corresponded to the beginning of a family, "living together" becomes more and more popular ; small families are replacing large families ; family planning becomes almost universal while more or less efficient contraceptive techniques are replaced by the most efficient ones; on the other hand, the marriage stability, formerly insured by an irrevocable commitment, is questionned as the rapidly increasing divorce rate shows. The second section examines the effects of these changes on the family environment of children ; it is shown that children born today are living in a more limited family environment : they will have only one brother or sister and very few cousins. Before they reach their majority very few will see the death of one of their parents ; however, the probability of seeing their parents obtain a divorce is increasing substantially, and a higher percentage of children will be raised in a lone parent family, by their mother in most cases. The observer is witnessing a rapid multiplication of various conjugal and family situations ; but no new dominant pattern has yet emerged.

English Abstract↗
PubMed1985

Patterns of interaction in family relationships and the development of identity exploration in adolescence.

The purpose of this research was to develop a model of individuation in family relationships that focuses on communication processes, and to assess the links between them and adolescent identity exploration. Expressions of the 4 dimensions of the model--self-assertion, separateness, permeability, and mutuality--were predicted to be positively associated with identity exploration in adolescents. A sample of 84 Caucasian, middle-class, 2-parent families, each including an adolescent and 1 or 2 siblings, was observed in a Family Interaction Task designed to elicit the expression and coordination of a variety of points of view. Multiple regression analyses revealed differentiated results concerning father-son, father-daughter, mother-son, mother-daughter, and marital relationships as well as both positive and negative contributions of communication variables to identity exploration when verbal ability and sociability were controlled. Results are discussed in terms of recent formulations of the progressive redefinition of the parent-child relationship during adolescence.

Adolescent↗
PubMed1995

Fraser syndrome.

In a consanguineous marriage, a woman at 32 weeks' pregnancy presented with intrauterine growth retardation and bilateral renal agenesis. Fraser syndrome (cryptophthalmus syndactyly syndrome) was diagnosed based on cryptophthalmos, atresia of meatus acusticus externus in auricula, syndactyly, hypoplastic larynx, hypoplastic left lung, agenesis of urinary system and aberrant pancreas in duodenum. The syndrome is inherited as a recessive trait and the risk of recurrence is 25%.

Abnormalities, Multiple↗
PubMed1992

Congenital hypoparathyroidism, seizure, extreme growth failure with developmental delay and dysmorphic features--another case of this new syndrome.

A 4-year-old Saudi female child with extreme failure to thrive, striking dysmorphic features, developmental delay, congenital hypoparathyroidism, UTI, seizures, chronic otitis media, chronic non-specific gastroenteritis and repeated life-threatening infections was followed from birth. She was the product of first-cousin consanguineous marriage. She had striking facies with frontal prominence, deep-set eyes, depressed nasal bridge, beaked nose, long philtrum with thin upper lip, micrognathia, large floppy ears, bifid uvula, and growth retardation with SD score less than -2 for height, weight and head circumference. We believe these features which include congenital hypoparathyroidism, severe growth failure and developmental delay in the absence of chromosomal abnormality represent a newly described genetically determined syndrome.

Abnormalities, Multiple↗
PubMed2002

Comprehensive assessment of the elderly cancer patient: the feasibility of self-report methodology.

PURPOSE: Comprehensive geriatric assessment (CGA) has aided the medical community greatly in understanding the quality-of-life issues and functional needs of older patients. With its professional team assessment approach, however, CGA may be time consuming and costly. The goal of the present study was to assess the ability of cancer patients to complete a self-administered CGA and then to characterize cancer patients across multiple domains and age groups. PATIENTS AND METHODS: Two hundred sixty-six male outpatient oncology patients at the Durham Veterans Affairs Medical Center were asked to fill out a survey assessing 10 domains (demographics, comorbid conditions, activities of daily living, functional status, pain, financial well being, social support, emotional state, spiritual well-being, and quality of life). RESULTS: Seventy-six percent of the patients who received their surveys and kept their appointments returned the assessment tool. Older oncology patients had significantly less education (P <.0001), income (P =.05), frequent exercise (P =.01), and chance of being disease free (P =.003) than younger patients. Other findings in older patients were a higher rate of marriage (P =.02), more difficulty in taking medications (P =.05), and less cigarette (P =.03) and alcohol (P =.03) use. Members of all age cohorts reported a sense of social support, with younger patients deriving this more from family and friends than older patients, and older patients deriving social support more from membership in religious communities than younger patients. No differences were found across age groups for number and impact of comorbid illnesses, number of medications, basic and instrumental activities of daily living, pain, overall health rating, financial adequacy, anxiety, depression, and quality of life. CONCLUSION: CGA can be conducted in an outpatient cancer community using a self-report format. Despite the fact that this population varied demographically across age groups and is limited to veterans, this study demonstrated remarkable similarities between younger and older cancer patients in terms of functional status, health states, and quality of life.

Activities of Daily Living↗
PubMed1985

Isolation of infectious human T-cell leukemia/lymphotropic virus type III (HTLV-III) from patients with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC) and from healthy carriers: a study of risk groups and tissue sources.

Acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) are thought to be caused by human T-cell leukemia/lymphotropic virus type III (HTLV-III). Since the fall of 1982, independent isolates of HTLV-III have been obtained in this laboratory, in collaboration with several clinical groups, from 101 AIDS and ARC patients and healthy donors at risk for AIDS. Most isolates were from peripheral blood T lymphocytes established in cell culture, but some were obtained from bone marrow, lymph node, brain tissue, and cell-free plasma and from cells associated with saliva, cerebrospinal fluid, and semen. Virus was isolated from approximately 50% of AIDS patients, 85% of ARC patients, and 30% of healthy individuals at risk for AIDS. The risk groups included homosexuals, promiscuous heterosexuals, i.v. drug users, recipients of blood or blood products, and spouses and offspring of AIDS patients and others at risk for AIDS. A high correlation was seen between persistent levels of serum antibody and the ability to isolate virus from patient or donor leukocytes. Immunologic and nucleic acid analysis demonstrated that the virus isolates were highly related, although substantial diversity was observed in the restriction enzyme cleavage patterns of those studied in detail. Biological analysis of cells from infected patients and donors as well as from normal peripheral blood mononuclear cells exposed to virus in vitro demonstrated that OKT4/Leu3a+ (helper/inducer) lymphocytes were preferentially infected and were subjected to a characteristic cytopathic effect. The availability of multiple isolates of virus from a number of different patients and donors will greatly facilitate the characterization of HTLV-III and the study of possible biological and/or biochemical variants of the virus responsible for the development of AIDS, ARC, and related diseases.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Emerging geriatric challenge.

India is a vast country with diversity, both physical and cultural. 72% of World's second largest population live in rural experiencing varying degrees of socioeconomic change. However, there is no nationwide registry of older people and exact statistics about elderly population is not available. Community-based data on morbidity and disability are also not available. India is one of the few countries in the world where men out number women at all ages till about 70 years and only in very old age (80+) there are more women than men. One of the main social effect of extension of life in later years is the extended period of widowhood for women mainly due to cultural practice of men marrying younger women and widow marriage as well as divorce are uncommon. Much progress has been made in the health care services in the last 50 years giving much emphasis to mother and child programme with special emphasis on controlling population. But elderly population has been neglected, there is no separate ward for elderly in hospitals, no specialized courses in the Universities for training doctors and nurses for elderly care. Recently, Indian Medical Association has organized an ambitious project for rural elderly with emphasis on Geriatric care. Still recently, emphasis has been given for developing infrastructural facilities including creating training, courses on Geriatric Medicine and integrating with alternative system for better care of elderly. However, due to increasing awareness of policy makers to multiple issues related to aging, some progress has been made like old age pension scheme, income tax rebate for elderly, old homes and day care centers and law to help retired citizens in evicting tenants etc. but environment is not as elderly-friendly as in European countries, as the State is not likely to have adequate resources in the presence of other priorities in the country.

Aged↗
PubMed1982

Factors associated with parent labeling of children referred for conduct problems.

Clinicians have suggested that in some cases normal children have been inappropriately labeled as deviant by their parents and taken to psychological clinics for treatment. Reasons given for such inappropriate labeling have included factors such as the parents' marital distress and intolerance of normal child behavior. This study provided an empirical examination of the appropriateness or inappropriateness of parent labeling of 5--12-year-old children referred by their parents for treatment of conduct problems. The definition of inappropriate labeling derived by the present investigators required that the relationship between the child's actual behavior and the parent's negative label be so imperfect as to raise questions about the justification for the label, and that some identifiable factors other than the child's behavior account for the negative label. Three parent factors evaluated for their contribution to the parent negative label were martial distress, parent negative behavior toward the child, and parent distress about child deviant behavior. The statistical model of hierarchical multiple regression permitted analysis of this definition. The association found between observed child deviant behavior and the parent negative label suggested that parents of this sample perceived their children reasonably accurately. The three parent factors were found to be negligibly related to the parent label. Therefore, the conditions for inappropriate labeling of the children by the parents of this sample were not met.

Child↗