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PubMed1996

Translatability of family concepts into the Japanese culture: using the Family Environment Scale.

Family concepts and their measurements interest many family researchers. There is a question about the extent to which family concepts are universal or influenced by the culture in which the instrument originated. Using the Family Environment Scale (FES), the authors examine the translatability of family concepts into the Japanese culture. Forward- and back-translation processes and cross-cultural assessment of reliability and validity are discussed. We suggest that there may be different degrees of translatability for each of the family concepts used in the FES and that evaluation of families in different societies necessitates culturally appropriate constructs and instruments. The discussion is built around Japanese data, which are compared to the American results.

Cross-Cultural Comparison↗
PubMed2001

Engaging refugee families in therapy: exploring the benefits of including referring professionals in first family interviews.

The possible benefits of including referring professionals in the first family interviews are being explored as a way to engage refugee families in therapy. Families in exile confront a number of problems related both to premigration traumatic exposures and to present adaptation processes. Refugee clients and the referring professionals in the larger system frequently see the problems and their solutions quite differently. This situation may often result in unclear working alliances in a context of therapy. We will describe first family interviews in which referring professionals are interviewed about their reasons for referrals, and where the families are invited to discuss these considerations. The conversations permit families, referrers, and therapists to reflect upon differences in positions and perspectives. Their experiences suggest that agreements or contracts based on these joint interviews are less ambiguous and more clearly formulated than contracts based on interviews with families alone. Finally, these experiences are discussed as a potentially valuable approach in a cross-cultural context.

Adult↗
PubMed2002

Effects of family interaction on the child's behavior in single-parent or reconstructed families.

The effects of the family interaction on children's behavior were studied in single-parent or reconstructed families (N = 63) in a white population in Finland. The focus was on the spousal and the parent-child interaction. Teachers assessed children's behavior and parents were interviewed. The interviews were analyzed qualitatively using the grounded-theory method. The boundary ambiguity theory developed by Pauline Boss was used to examine the interaction in the families. About two fifths of the parents reported that their spousal interaction was good, family boundaries were clear, and the children were taken care of together. Another two fifths interacted only because of the child and family boundaries were ambiguous. In 14 families the involvement of the noncustodial parent was both physically and psychologically low. The physically close but psychologically distant parent-child interaction seemed to affect the child's behavior detrimentally, whereas children with physically and psychologically close interaction with their parents showed less behavioral problems. The children with behavioral problems were more likely to have problems with both parents. They were also more likely to have a stepparent with whom they had conflicts. In conclusion, a good interaction between the parents and clarified family boundaries protect children's mental health after their parents' divorce or separation.

Adaptation, Psychological↗
PubMed1990

Multigene families in African swine fever virus: family 360.

A group of cross-hybridizing DNA segments contained within the restriction fragments RK', RL, RJ, and RD' of African swine fever virus DNA were mapped and sequenced. Analysis of these sequences revealed the presence of a family of homologous open reading frames in regions close to the DNA ends. The whole family is composed of six open reading frames with an average length of 360 coding triplets (multigene family 360), four of which are located in the left part of the genome and two of which are in the right terminal EcoRI fragment. In close proximity to the right terminal inverted repeat, we found an additional small open reading frame which was homologous to the 5'-terminal portion of the other open reading frames, suggesting that most of that open reading frame has been deleted. These repeated sequences account for the previously described inverted internal repetitions (J.M. Sogo, J.M. Almendral, A. Talavera, and E. Viñuela, Virology 133:271-275, 1984). Most of the genes of multigene family 360 are transcribed in African swine fever virus-infected cells. A comparison of the predicted protein sequences of family 360 indicated that several residues are conserved, suggesting that an overall structure is maintained for every member of the family. The transcription direction of each open reading frame, as well as the evolutionary relationships among the genes, suggests that the family originated by gene duplication and translocation of sequences between the DNA ends.

Amino Acid Sequence↗
PubMed1997

A family clinic--optimising care for HIV infected children and their families.

A family clinic providing specialist paediatric and adult medical, testing, counselling, and terminal care services for families living with HIV was set up at a paediatric tertiary care hospital in London in 1991. During the first five years, until April 1996, 185 children from 149 families attended, including 119 infected children, of whom 32 have died. Only 5% of mothers were born in the UK; the rest were born in 24 different countries, the majority in sub-Saharan Africa. Less than a quarter of children were cared for by both parents, 61% by mothers alone, and 11% by guardians or foster parents. Of the adult attendees, 76% were women, and more than half were untested when they first attended the clinic. Provision of a family planning service within the family clinic was initiated as a result of women presenting with unplanned pregnancies. Shared care with local clinics is increasing, but with the complexity around the management of paediatric HIV infection, particularly with regard to antiretroviral treatments, there is need for continued specialist input. Coordination among specialist and locally based family services is required to provide flexible, accessible, and up to date care for families living with HIV infection in London.

Adolescent↗
PubMed2003

Pre-test prediction models of BRCA1 or BRCA2 mutation in breast/ovarian families attending familial cancer clinics.

OBJECTIVE: To test whether statistical models developed to calculate pre-test probability of being a BRCA1/2 carrier can differentiate better between the breast/ovarian families to be referred to the DNA test laboratory. STUDY DESIGN: A retrospective analysis was performed in 109 Spanish breast/ovarian families previously screened for germline mutations in both the BRCA1 and BRCA2 genes. Four easy to use logistic regression models originally developed in Spanish (HCSC model), Dutch (LUMC model), Finnish (HUCH model), and North American (U Penn model) families and one model based on empirical data of Frank 2002 were tested. A risk counsellor was asked to assign a subjective pre-test probability for each family. Sensitivity, specificity, negative and positive predictive values, and areas under receiver operator characteristics (ROC) curves were calculated in each case. Correlation between predicted probability and mutation prevalence was tested. All statistical tests were two sided. RESULTS: Overall, the models performed well, improving the performances of a genetic counsellor. The median ROC curve area was 0.80 (range 0.77-0.82). At 100% sensitivity, the median specificity was 30% (range 25-33%). At 92% sensitivity, the median specificity was 42% (range 33.3-54.2%) and the median negative predictive value was 93% (range 89.7-98%). BRCA1 families tended to score higher risk than BRCA2 families in all models tested. CONCLUSIONS: All models increased the discrimination power of an experienced risk counsellor, suggesting that their use is valuable in the context of clinical counselling and genetic testing to optimise selection of patients for screening and allowing for more focused management. Models developed in different ethnic populations performed similarly well in a Spanish series of families, suggesting that models targeted to specific populations may not be necessary in all cases. Carrier probability as predicted by the models is consistent with actual prevalence, although in general models tend to underestimate it. Our study suggests that these models may perform differently in populations with a high prevalence of BRCA2 mutations.

BRCA1 Protein↗
PubMed1984

The effects of familial relationships, age, body weight, and diet on blood pressure and the 24 hour urinary excretion of sodium, potassium, and creatinine in men, women, and children of randomly selected families.

Two hundred thirty-three randomly selected families provided a population for studying the effects of familial relationships, age, diet, body weight, and urinary electrolyte excretion on blood pressure. There was a strong familial component for urinary sodium, potassium, and creatinine excretion and for systolic blood pressure. In individuals, age, heart rate, and body weight were independently related to blood pressure. In women, urinary sodium and potassium levels were related to diastolic blood pressure. These individual relationships persisted when age was accounted for but were no longer significant after adjusting for both age and body weight, suggesting that heavier people eat more food, which in our culture means greater sodium intake. In fact, our randomly selected families were eating as much sodium (130 to 170 meq/day) and as little potassium (50 to 70 meq/day) as consumed by Americans several decades ago. Furthermore, this study again documented the rise in blood pressure with age, which may represent the effect of environmental influences on blood pressure over time. The familial aggregation of urinary sodium, potassium, and creatinine excretion, along with the well-established familial aggregation of body weight, emphasizes the importance of the entire family in the treatment and prevention of hypertension.

Adolescent↗
PubMed2005

Family structure and mental health: the mediating effects of socioeconomic status, family process, and social stress.

Although numerous studies reveal differences in mental health by the structure of one's family of origin, there remains debate regarding the processes generating these patterns. Using a sample of young adults (19-21 years) in Miami-Dade County in Florida, this study examines the explanatory significance of three presumed correlates of family type: socioeconomic status, family processes, and level of social stress. Consistent with prior research, our results reveal higher levels of depressive symptoms among those from stepfamilies, single parent families, and single parent families with other relatives present, compared with mother-father families. All three presumed correlates make significant independent contributions to the prediction of depressive symptomatology. Substantial mediating effects also are observed for all three explanatory dimensions. Collectively, they completely or largely explain observed family type variations in mental health risk.

Adult↗
PubMed2006

The persistence of family: a study of a nineteenth-century Canadian family and their correspondence.

Beginning in the 1850s, the struggling farming family of Elijah Dunham (1810-1893) and Anna Maria Briggs (1813-1899) ceased to function as a single economic and social unit. The children left the family home to establish lives and families of their own in various parts of Canada and the United States. As the family dispersed, however; they continued to maintain contact through letters. In the letters, the family shared news, sought advice, received comfort, and, at times, vented their frustrations and exposed internal family tensions. The letters provided a means of requesting and extending financial assistance, especially as it came to maintaining the elderly parents back in Ontario. Although the family would never again inhabit the same geographic location, they continued to function as a kinship network even though separated by time and space.

Canada↗
PubMed2003

Family dynamics in biblical times: Joseph as a family psychotherapist.

Families have existed for thousands of years and are the most enduring form of small social group. This article discusses the family of Jacob as described in the Bible, and analyses the dynamics of the family system, the relationships between family members and the ways in which they interact and respond to stressful events. Such events disrupted the equilibrium of the family and led to a severe crisis, but this was eventually resolved peacefully and family members were reconciled. The story of Joseph, Jacob's son, unfolds as possibly the earliest description of a psychotherapeutic intervention to resolve a long-standing family crisis.

Bible↗
PubMed2004

Family-based clusters of cognitive test performance in familial schizophrenia.

BACKGROUND: Cognitive traits derived from neuropsychological test data are considered to be potential endophenotypes of schizophrenia. Previously, these traits have been found to form a valid basis for clustering samples of schizophrenia patients into homogeneous subgroups. We set out to identify such clusters, but apart from previous studies, we included both schizophrenia patients and family members into the cluster analysis. The aim of the study was to detect family clusters with similar cognitive test performance. METHODS: Test scores from 54 randomly selected families comprising at least two siblings with schizophrenia spectrum disorders, and at least two unaffected family members were included in a complete-linkage cluster analysis with interactive data visualization. RESULTS: A well-performing, an impaired, and an intermediate family cluster emerged from the analysis. While the neuropsychological test scores differed significantly between the clusters, only minor differences were observed in the clinical variables. CONCLUSIONS: The visually aided clustering algorithm was successful in identifying family clusters comprising both schizophrenia patients and their relatives. The present classification method may serve as a basis for selecting phenotypically more homogeneous groups of families in subsequent genetic analyses.

Adult↗
PubMed2006

Health inequality in adolescence. Does stratification occur by familial social background, family affluence, or personal social position?

BACKGROUND: Two new sets of stratification indicators--family's material affluence and adolescent's personal social position- were compared with traditional indicators of familial social position based on parental occupation and education for their ability to detect health inequality among adolescents. METHODS: Survey data were collected in the Adolescent Health and Lifestyle Survey in 2003 from nationally representative samples of 12-, 14- and 16-year-old Finns (number of respondents 5394, response rate 71%). Indicators of the familial social position were father's socio-economic status, parents' education, parents' labour market position. Indicators of material affluence were number of cars, vacation travels, and computers in the family, own room and amount of weekly spending money. Adolescent's personal social position was measured as school performance. Measures of health were long-standing illness, overweight, use of mental health services, poor self-rated health and number of weekly health complaints. Ordinal logistic regression analysis was applied to study the associations between stratification indicators and health variables. RESULTS: All three groups of indicators of social stratification showed inequality in health, but the strongest associations were observed with the adolescent's personal social position. Health inequality was only partly identifiable by the traditional indicators of familial social position. The direction of the inequality was as expected when using the traditional indicators or personal social position: adolescents from higher social positions were healthier than those from lower positions. The indicators of family's material affluence showed mainly weak or no association with health and some of the indicators were inversely associated, although weakly. CONCLUSION: In addition to traditional indicators describing the socio-structural influences on the distribution of health among adolescents, indicators of family's material affluence should be further developed. Adolescents' personal social position should be included in the studies of health inequalities.

Adolescent↗
PubMed1986

The impact of individual and family treatment on the affective climate of families of schizophrenics.

Measures of parental affective style were compared for families of schizophrenics participating in a controlled treatment study which contrasted individual and family-based therapeutic programmes. The total number of critical statements and non-critical, intrusive remarks was significantly lower after three months for parents of schizophrenics participating in family therapy, compared to those whose offspring received only individual therapy. An increased risk for relapse was associated with an increase in the number of critical and/or intrusive remarks for patients in individual treatment. A significant increase in non-emotional, problem-solving statements was observed in parents who received family therapy, compared with those who did not. The results suggest that a behaviourally-oriented, problem-solving family approach may have reduced the risk of relapse in the first nine months after discharge from hospital by teaching families concrete ways of solving problems and concomitantly reducing the amount of negative emotional relating between family members.

Adolescent↗
PubMed1996

How familial is familial tremor? The genetic epidemiology of essential tremor.

Essential tremor (ET) is commonly assumed to be partly genetic. This is due to a seemingly excess aggregation within certain families. There are many families containing more than one member with ET, and some large kindreds with multiple affected individuals. Despite this, the proportion of ET cases with affected family members is not known. Estimates vary from 17 to 100%. Additionally, none of the published studies employed control subjects. Therefore, it is unknown to what extent ET aggregates within families beyond that expected by chance, and the importance of genetic susceptibility in the etiology of ET at the population level has not been established. Additionally, whether or not some clinical subtypes of ET are more likely than others to be influenced by genetic susceptibility is unclear. Some studies suggest that early-onset ET may be familial, although increased awareness and earlier recognition of symptoms is an issue. Although many data support the view that ET susceptibility is inherited in an autosomal dominant manner, most studies are kindreds or service-based studies that might favor selection of families with apparent autosomal dominant modes of inheritance. One community-based study suggested an autosomal dominant mode of inheritance, but this has not been confirmed in studies of more heterogeneous populations. Further understanding of the extent of familial aggregation, extent of genetic heterogeneity, and mode of inheritance is essential for clinical counseling and for further research aimed at localizing and identifying susceptibility genes.

Disease Progression↗
PubMed2003

Families in palliative care: exploring family and health-care professionals' beliefs.

At the terminal stage of a disease, health professionals are encouraged to extend the scope of their interventions to include the family. However, clinicians often feel powerless when confronted with the suffering that family members experience. According to Wright, suffering is intimately related to family beliefs. These beliefs suffuse their experience of the illness and determine their understanding of the disease, the choice of treatment and compliance with a programme of care. Moreover, clinicians' own beliefs affect their sense of control over the patient and his or her family's suffering. This article suggests interventions that target families' and clinicians' beliefs and attempt to ease the dying process in a context of palliative care. These interventions consist of: acknowledging and challenging health-care professionals' own beliefs; exploring and challenging constraining beliefs of the patient and the family; and supporting beliefs that offer hope. These interventions can empower health professionals and families in their efforts to alleviate suffering related to the terminal phase of an illness.

Attitude to Death↗
PubMed2001

Keeping it in the family: caregiving in Australian-Greek families.

Family-based caregiving refers to the daily provision of help to a co-resident family relative with the usual activities of daily living, custody and protection of a dependent relative at risk of self-injury, and support of a person with physical, developmental and/or mental disability or frailty due to ageing. Many reports from western studies refer to the caregiving burdens, stress and strains. A common view of migrant peoples is that they 'look after their own' to a greater extent than do English-speaking groups and that their closer connections with ethno-specific community organisations and with their extended family networks provides more opportunities for assistance and support so that caregiving is shared and the burdens are reduced. A study was carried out with 300 Australian-Greek families in Melbourne where 150 were providing family-based caregiving, and these were age and gender matched with friends or acquaintances who had no such duties. Most care was provided by women, although almost 20% of carers were men. A wide range of disabilities and illnesses were receiving help and care in the caregiving families among care recipients aged from childhood to advanced old age. Distinct evidence of caregiving burden was found to a significant degree. Gender differences were apparent in the type of disorders managed, in the perceived severity of caregiving duties provided and in the total range of activities engaged in. The ethno-specific community organisations and extended family networks played little part in providing assistance to caregivers which challenges the myths of a close-knit migrant community looking after its own. Qualitative reports of concerns for future caregiving were expressed and the implications for future service needs are discussed.

Adolescent↗
PubMed2006

Family structure and income inequality in families with children, 1976 to 2000.

Using 24 years of data from the March supplements to the Current Population Survey and detailed categories of family structure, including cohabiting unions, I assess the contribution of changes in family structure to the dramatic rise in family income inequality. Between 1976 and 2000, family structure shifts explain 41% of the increase in inequality, but the influence of family structure change is not uniform within this period or across racial-ethnic groups. In general, the estimated role of family structure change is inversely related to the magnitude of the changes in inequality. Furthermore, by including cohabitation, I find lower levels of total inequality and a weaker role for demographic shifts in family structure for trends in income inequality.

Adolescent↗
PubMed2006

Basic family budgets: working families' incomes often fail to meet living expenses around the United States.

The ability of families to meet their most basic needs is an important measure of economic stability and well-being. While poverty thresholds are used to evaluate the extent of serious economic deprivation in our society, family budgets--that is, the income a family needs to secure safe and decent-yet-modest living standards in the community in which it resides--offer a broader measure of economic welfare. Basic family budgets take into account differences in both geographic location and family type. In total, this report presents basic budgets for more than 400 U.S. communities and six family types (either one or two parents with one, two, or three children). That the budgets differ by location is important, since certain costs, such as housing, vary significantly depending on where one resides. This geographic dimension of family budget measurements offers a comparative advantage over using poverty thresholds, which only use a national baseline in their measurements.

Adolescent↗