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The gardner syndrome. A study in cell culture.

Tetraploidy was increased in skin fibroblast cultures derived from three probands with the Gardner syndrome and nine affected members of one family as compared to that occurring in cultures from five unaffected family members as well as from six relatives by marriage and 15 normals grown in the laboratory at the same time under the same conditions. Tetraploidy was present at the first subculture (2 weeks after the initial biopsy was cultured) and for each line studied the percentage of dividing cells showing tetraploidy remained constant. Increased occurrence of tetraploidy was not observed in skin fibroblast cultures from patients with the genetic disorders familial polyposis coli, familial osteomas, and familial fibromatosis (neurofibromatosis), each of which show one of the four abnormal tissue growths observed in the Gardner syndrome. The relationship of the observed tetraploidy to the increased risk of such patients to develop abnormal growths and cancer has not been established. The increased tetraploidy should be of value in identifying the presence of the gene for the Gardner syndrome in high risk families.

Adolescent↗

Family structures of narcotic addicts.

Seventy-five families of former narcotic addicts were studied in New York City and Los Angeles. All patients were in residential treatment at the time of the study and they and their families participated in a multiple family group which was the major source of data. The most common familial pattern seen was that of a mother enmeshed with her addicted son. The father feels excluded by this dyad and reacts with disengagement, brutality, or increased consumption of alcohol. However, in certain ethnic groups the entire family including the father is quite enmeshed with each other and their addict sons. Siblings were either fellow addicts whose drug abuse is fused with that of the identified patient or, to the contrary, "good' children who were parental figures and quite successful. Addict spouse pairs tend to duplicate patterns which they have developed in their family of origin. Male addicts frequently dominate their addicted or drug-free spouse to assure themselves of being cared for. The female addict population in this study was too small (N = 16) for generalization but observed patterns are discussed.

Dependency, Psychological↗

Second-hand prostatism: effects of prostatic symptoms on spouses' quality of life, daily routines and family relationships.

OBJECTIVES: The aim of this study was to explore the impact of male prostatic symptoms on their partners' quality of life, daily routines and family relationships. METHODS: A structured telephone interview study was carried out on a random sample of 215 of the wives and partners of men aged 50 years or older drawn from those registered at four family medicine centres in Israel. They were asked about sleep disturbances, number of night-time wakings, and the effect on sexual relations, travel, entertainment, family and social relationships. RESULTS: The vast majority of women (86%) were affected by their partners' prostatism, with multiple consequences for their daily routines, quality of life and relationships. Sleep was the area of greatest concern, with 46% of women regularly waking due to their partners' urination disorder. The women reported other limitations: 37% noted problems with sexual functioning; 17% were unable to take long trips with partners; 10% could not visit places without toilets; while 8% were unable to go to the cinema or theatre. Women felt that their partners' prostatic symptoms were also to be blamed for upsetting family relationships (10%) and relationships with friends (16%). There was near total correspondence between women and their male partners regarding the effects of prostatic symptoms. CONCLUSIONS: Prostatism has an impact on men and women; strategies that consider the whole couple should be developed and utilized when considering treatment options.

Comorbidity↗

Patterns of economic change surrounding the death of a spouse.

The timing of economic changes near the death of a spouse is not well understood. Using multiple regression analysis and longitudinal data from the Panel Study of Income Dynamics, the economic situations of middle-aged and older widows and widowers were compared to those of otherwise similar intact couples over an 11-year period. The analysis shows that all four widowed groups had fewer economic resources 5 years after the death than did their married counterparts. Yet, each group took very different economic paths to get to this point. For example, older widows and widowers begin the analysis with significantly lower income-to-needs ratios 5 years prior to the death, while middle-aged widows experience more economic change near the time of the death. These findings suggest that both middle-aged and older cohorts of widowed individuals may have made consumption choices over the life cycle that differ from those made by their intact counterparts.

Age Factors↗

[Experiences of breast reconstruction following mastectomy in cases of cancer and evaluation of psychological aspects of the patients].

The breasts are one of the symbols of femininity. Even if it is for the treatment of cancer, the loss or deformity of the breast brings a considerable psychological burden in addition to the physical pain. Authors have performed breast reconstruction on 150 cases during the past fifteen years and have obtained largely favorable results, which were already reported in several papers. Authors administered questionnaires to these patients in order to ascertain their candid opinions which are often not expressed in a hospital. The results of the survey are presented in this report. The survey was conducted anonymously and the questions were all multiple-choices. Approximately 82% of the patient responded. About the pain, inconvenience and motives for undergoing reconstruction, there was a wide variety of answers and many of those surprised authors. For instance; hesitant to go to a hot spring, or on a trip with friends (76%), hesitant to go to a clinic or a hospital for physical check-ups and common illness (74%), troublesome to wear special underwear (69%), inconvenient because ordinary clothes cannot be worn (56%), distressed when viewing own body (52%), unable to dress in thin clothes in hot summer season (50%), imbalance of the breasts (49%), inconvenient to participate in sports (47%). The most patients experienced inconveniences in daily life and had mental and emotional problems. Overall, an impression of the results of breast reconstruction was 83% satisfactory or near satisfaction. About the condition after reconstruction: Patients also expressed a wide variety of opinions about the improvements. For instance, they are relieved from the troubles of wearing special clothing and enjoy selecting and shopping for clothes. They are able to walk on the street with dignity. They enjoy hot spring baths, sports, and leisure activities. They can go for physical check-ups without hesitation. They have a sense of liberation, and become free from constant anxiety. They developed again a forward-looking and positive attitude. Some patients say that they forgot that they had breast reconstruction and that they had breast cancer. As for marriage after reconstruction, which seems to be author's ultimate goal, 12 of the 52 single women have married, and another 22 are currently planning to marry. To the question, "If you are consulted by someone who is in a similar situation". 99% said they would recommend the reconstruction.(ABSTRACT TRUNCATED AT 400 WORDS)

Breast↗

A study of longitudinal patterns of substance abuse with special reference to multiple use problems.

1. Sequential patterns of abuse were analyzed in 222 subjects of substance abuse who had admitted mental hospitals. They were classified into four patterns and seven sub-patterns. 2. Alcohol alone type (Pattern I) was different from other patterns of abuse in their initiating ages, family status and the levels of social life. A marked tendency to multiple abuse was found in Pattern II and III including organic solvents and/or methamphetamine. 3. However, even in Pattern II and III, alcohol abuse was found in 18% of the subjects. This suggests alcohol is an important hidden substance in multiple drug abusers. 4. Many substance abusers without alcohol had also alcoholics in their family members. Especially those who initiated their abuse in early ages are supposed to have constitutional and family factors which are common to alcohol and drugs. 5. Patterns II and III of organic solvents and methamphetamine abuse, the existence of peers and their strong influence upon users were of prime importance. Initiation of abuse from an early age and disruption of social life were marked in those patterns. 6. Many alcoholics started their abuse in earlier ages than expected. The study shows that there were two groups; the group whose social lives had been disrupted at early ages, and the one whose level of social life had been maintained. 7. Physical illnesses were mostly found in the patterns which include alcohol abuse.

Adolescent↗

Battered baby syndrome at Kenyatta National Hospital, Nairobi.

Thirty children presenting with Battered Baby Syndrome over a five year period were studied retrospectively. The male:female ratio was 1:1.1. The majority (60%) were aged 0-11 months. 14 children (46%) were abandoned while six (20%) had multiple fractures, six (20%) multiple bruises and bites, and four (13.3%) had other forms of abuse. Twelve (40%) children were malnourished while eight of the babies (26.6%) were small for gestational age. Children were most frequently brought to hospital by the police or their mothers. The children were most frequently abused by their mothers either through abandonment or through physical battering. Details of mothers of the 14 abandoned children were unknown. Among the mothers of the other children, nine mothers were single, seven married and living with spouses and one stepmother. Two children (6.6%) died while the fate of two others was not known. Three children were sent home without intervention of the social worker, while twenty three children were discharged following intervention of the social worker; fourteen sent home, nine to a childrens' home and one through the juvenile court.

Adolescent↗

Parental alcoholism as a risk factor for DSM-IV-defined alcohol abuse and dependence in American women: the protective benefits of dyadic cohesion in marital communication.

Important trends in research over the past decade indicate that women are as greatly affected by familial alcoholism as are men. Although it is increasingly recognized that the adverse drinking outcomes predicted for adult children of alcoholics (COAs) are not inevitable, and only a small percentage develop alcohol dependence or grow up to be alcoholic, relatively little knowledge exists regarding moderating factors that reduce their vulnerability. This study identifies a multiple mediator latent structural model of the intergenerational transmission of risk for DSM-IV-assessed alcohol abuse and dependence among women COAs in adulthood. The effects of both parental alcoholism and family environment are estimated at three time points spanning 10 years across 5-year intervals (1984, 1989, and 1994) using data from a subsample of 4,449 women in the National Longitudinal Survey of Youth (NLSY). Dyadic cohesion in marital communication (greater marital cohesion, harmony, and less verbal disagreement, discord, and conflict) is a proposed moderating factor that may operate in adulthood to lower the risk of female COAs developing alcohol abuse and dependence. Maximum likelihood standardized estimates of the effects of alcohol mediators measured over time indicate that direct parental effects for adverse outcomes decline when COAs are in their late 20s and early 30s. Indirect parental effects through environmental influences dramatically increase the risk of abuse and dependence among COAs at this time if they have one or more alcoholic siblings, especially an alcoholic sister. Dyadic cohesion and positive interpersonal communication patterns were found to moderate effectively the relationship that existed among parental alcoholism, environmental influences, and adverse alcohol consequences. COAs with satisfactory marital communication also evidenced higher levels of intimacy with their partners, perceived the division of housework to be fairer, shared more responsibilities and burdens of the household, and had less conflict over critical domestic issues than other women COAs. The protective benefits of a good marriage against the risks of alcoholism remained when applied to younger and older subjects, across diverse backgrounds, and after adjusting for other factors such as employment status.

Adolescent↗

Categories and continua of destructive and constructive marital conflict tactics from the perspective of U.S. and Welsh children.

Categories and continua of parents' marital conflict tactics based on multiple, conceptually grounded criteria were tested. Participants were 175 U.S. children, ages 8-16 years (88 boys, 87 girls) and 327 Welsh children, ages 11-12 years (159 boys, 168 girls). Children's responses (affective, cognitive, behavioral) to analog presentations of 10 everyday marital conflict tactics enacted by fathers or mothers showed substantial variation as a function of tactic used. Orderings of conflict tactics on the various response criteria varied as a function of moderators, particularly the gender of the parent expressing the conflict tactic. Conflict tactics were classified as either constructive or destructive according to criteria derived from the emotional security hypothesis. Except for calm discussion, classifications did not change regardless of cultural group, parent gender, or child age or gender. Recommendations for negotiating everyday marital conflict for the children's sake are discussed.

Adaptation, Psychological↗

Is race associated with weight change in US adults after adjustment for income, education, and marital factors?

We examined the 10-y change in body mass index (BMI, in kg/m2) of black and white adults who entered the First National Health and Nutrition Examination Survey Epidemiologic Followup Study at ages 25-44 y. In women the mean change in BMI was greater for blacks than for whites despite multiple adjustments. However, the risk of major weight gain (MWG; BMI change greater than or equal to + 5) was nearly identical in black and white women. Womens' MWG was independently associated with low income [odds ratio (OR) = 1.7] and with becoming married (OR = 1.8). The risk of major weight loss (MWL; BMI change less than or equal to -2.5) was lower in black women than in white women (OR = 0.6). In men mean BMI change, MWG (BMI change greater than or equal to + 4) and MWL (BMI change greater than or equal to -2) were not associated with race, but there were effects associated with low income, low education, and marital changes. Black race does not increase the risk of weight gain; in women it may be associated with a reduced likelihood of weight loss.

Adult↗

Infant mortality statistics from the 2002 period: linked birth/infant death data set.

OBJECTIVES: This report presents 2002 period infant mortality statistics from the linked birth/infant death data file by a variety of maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. METHODS: Descriptive tabulations of data are presented and interpreted. RESULTS: The U.S. infant mortality rate increased from 6.8 infant deaths per 1000 live births in 2001 to 7.0 in 2002. The rate for infants of non-Hispanic white mothers was 5.7 in 2001 compared with 5.8 in 2002. The rate for infants of non-Hispanic black mothers was 13.5 in 2001 compared with 13.9 in 2002. Neither of the changes for non-Hispanic white nor non-Hispanic black was significant. Between 2001 and 2002, overall cause-specific rates increased 5 percent for low birthweight and 14 percent for maternal complications. The rate rose significantly for infants of mothers who smoked, 10.5 to 11.1. It also increased significantly from 10.7 to 11.5 for infants of mothers aged 15-17 years. The rate dropped significantly for triplet births, 71.4 to 60.1. Infant mortality rates ranged from 3.0 per 1000 live births for Chinese mothers to 13.9 for non-Hispanic black mothers. Among Hispanics, rates ranged from 3.7 for Cuban mothers to 8.2 for Puerto Rican mothers. Infant mortality rates were higher for those infants whose mothers were born in the 50 States and the District of Columbia, were unmarried, or smoked during pregnancy. Infant mortality was also higher for male infants, multiple births, and infants born preterm or at low birthweight. The three leading causes of infant death-Congenital malformations, low birthweight, and Sudden infant death syndrome (SIDS)-taken together accounted for 45 percent of all infant deaths. For infants of non-Hispanic black mothers, the cause-specific infant mortality rate for low birthweight was nearly four times that for infants of non-Hispanic white mothers. For infants of non-Hispanic black and American Indian mothers, the SIDS rates were at least double the rate for non-Hispanic white mothers. A more intensive analysis of the rise in the infant mortality rate utilizing information on maternal and infant health risk factors available in the linked birth/infant death and fetal death data files is forthcoming.

Adult↗

Health inequalities in later life in a social democratic welfare state.

The paper examines inequalities in mental health and "serious" illness, i.e. illness with significant consequences, among 964 men and women aged 65 and over in Norway. The aim is to analyse the extent to which the assumed class differentials in ill health in later life are accounted for by current socioeconomic circumstances and social and economic conditions during upbringing. Multiple logistic regression analyses suggest that the bivariate relationship between previous class location and present health condition among elderly men remains or may be attributed to current income. For women, their previous class location is not significantly related to either health outcome. However, women's current income and present economic difficulties are significantly related to both health measures in the expected direction. In addition, serious illness is related to long-standing illness in childhood, and poorer mental health is associated with economic hardship in childhood and dissension in the family of upbringing. For neither sex was father's social class during upbringing an important predictor of ill health. It is concluded that health inequalities in later life may, at least to some extent, be attributed to the "legacy of the past", and that the social democratic welfare state has not succeeded in eradicating health inequalities despite its egalitarian age pension policy.

Aged↗

Birth weights in three Norwegian cities, 1860-1984. Secular trends and influencing factors.

Data from birth records from three maternity hospitals in Norway have been used to study the trend in birth weight in this country from 1860-1984. The investigation is based on a sample of 200-300 records taken at random from 2 to 5 years around every 10th year, from each of the three maternity hospitals--amounting to a total sample of 9152 women. Besides describing the trend in birth weight, I have analysed the different factors influencing birth weight--using multivariate linear regression methods. The results show that the mean birth weight has changed remarkably little throughout this period of 120 years. The total increase has only been just below 200 g. From Montreal, Ward and Ward (1984) have reported a decrease in mean birth weight of about 430 g during the second half of the last century. The Norwegian data indicates a simultaneous fall in mean birth weight of about 70 g. This fall is, however, found mainly among unmarried women. Thus, the great decline in birth weight which is found in Montreal, is not apparent in our material from Norway, despite the fact that Oslo was industrialized at approximately the same time as Montreal. Of the various independent variables used in the multiple regression analyses, only the following variables appear to be of any importance: the year when the birth took place, the mother's menarcheal age, her marital status, the sex of the child and the parity number. In this material, I have found a linearly increasing birth weight from birth number 2 up to at least parity 8, and a larger increase from parity 1 to 2. The birth weight shows a significant increase in the case of married women as opposed to unmarried. This effect is most marked before 1900, indicating that the social conditions gradually became less unequal after the turn of the century. The birth weights have a decreasing tendency with higher ages of menarche. This tendency is constant throughout the whole period of time. Boys appear to be about 112 g heavier than girls, this difference being largely the same throughout the investigated period.

Age Factors↗

Men who do not drink: a report from the British Regional Heart Study.

Men who do not drink are frequently used as a baseline against which the effects of alcohol consumption are measured. The characteristics of such men have been examined in a large-scale prospective study of cardiovascular disease involving 7735 middle-aged men drawn from general practices in 24 British towns. Non-drinkers include lifelong teetotallers and ex-drinkers, both long-term and recent. Long-term ex-drinkers have many characteristics likely to increase their morbidity and mortality; recent ex-drinkers have similar characteristics but to a less marked degree. Ex-drinkers are older than the other groups and include an increased proportion of unmarried men and men in manual occupations. They have the same high percentage of current cigarette smokers as moderate/heavy drinkers and a prevalence of hypertension and obesity similar to moderate/heavy drinkers and higher than lifelong teetotallers or occasional/light drinkers. Ex-drinkers have the highest percentage of men with multiple doctor-diagnosed disorders. In particular, they have the highest prevalence rates of angina and possible myocardial infarction on standardized questionnaire, of myocardial infarction on electrocardiogram and of recall of a doctor-diagnosis of ischaemic heart disease. They also have high prevalence rates of recall of high blood pressure, peptic ulcer, diabetes, gall bladder disease and bronchitis. They have the highest rates for regular medical treatment and the highest proportion of men who consider their health to be poor. It is abundantly clear that the general category of non-drinkers, which includes a large proportion of ex-drinkers, should not be used as a baseline against which to measure the effects of alcohol consumption. Overall, it would appear that the occasional/light drinking category (less than 15 drinks/week) provides a large and satisfactory baseline group for comparative purposes in the study of cardiovascular and other organic disorders.

Adult↗

Epidemiology of life events: frequency in general populations.

The objective was to provide additional background information for a refinement of life events methodolgy. Data about life events for a one year period were gathered from a representative sample of the population in Kansas City, Missouri, and Washington County, Maryland, between 1971-1974. Using binary variable multiple regression, the relationships between individual events, overall scores and demographic variables were examined for 2780 subjects. Age, education, marital status, location and race were shown to be significantly related to scores of one or more on the life events scale. Individual items were also related to these and other demographic variables. Fifteen individual events were shown to be moderately related to one another, so that when one event occurred the other was likely to occur also. Because different subgroups of the population experience different frequencies of total life events and of particular individual events, life events scores can vary considerably from group to group, depending on demographic composition and the appropriateness of the life events list for each demographic subgroup. Such relationships, if not adjusted for, could lead to coincidental associations between life events and health-related outcomes.

Adolescent↗

Infant mortality statistics from the 2001 period linked birth/infant death data set.

OBJECTIVES: This report presents 2001 period infant mortality statistics from the linked birth/infant death data set (linked file) by a variety of maternal and infant characteristics. METHODS: Descriptive tabulations of data are presented and interpreted. RESULTS: Infant mortality rates ranged from 3.2 per 1,000 live births for Chinese mothers to 13.3 for black mothers. Among Hispanics, rates ranged from 4.2 for Cuban mothers to 8.5 for Puerto Rican mothers. Infant mortality rates were higher for those infants whose mothers were born in the 50 States and the District of Columbia, were unmarried, or smoked during pregnancy. Infant mortality was also higher for male infants, multiple births, and infants born preterm or at low birthweight. The three leading causes of infant death--Congenital malformations, low birthweight, and Sudden infant death syndrome (SIDS)--taken together accounted for 44 percent of all infant deaths. Cause-specific mortality rates varied considerably by race and Hispanic origin. For infants of black mothers, the cause-specific infant mortality rate for low birthweight was nearly four times that for infants of white mothers. Between 1995 and 2001, the overall infant mortality rate declined by 10.5 percent; significant declines ranged from 8.2 percent for infants of non-Hispanic black mothers to 14.3 percent for infants of Hispanic mothers. The SIDS rate declined by 11 percent from 2000 to 2001. For infants of black and American Indian mothers, the SIDS rates were 2.2 and 2.8 times that for non-Hispanic white mothers.

Adult↗

A comparative study of the impact of education vs. process groups for families of patients with affective disorders.

This clinical project compares the relative impact of two types of multiple family groups on psychiatric inpatients and their families. Forty patients with a diagnosis of affective disorder, and their family members, were randomly assigned to a traditional multiple family group with a process orientation that emphasized support, destigmatization, and self-help about common problems; or to a psychoeducational multiple family group that emphasized the provision of information about the patient's illness and methods of coping with it effectively. Both groups, which met for four hours on a Saturday afternoon, were an integral part of an ongoing inpatient program specializing in the treatment of affective disorders. Pre- and post-measures were obtained regarding family and patient knowledge about affective disorders, level of personal distress, attitudes about the illness, and dyadic adjustment. In addition, both patients and family members were asked to rate their satisfaction with the group experience. A number of differences in knowledge, attitude and dyadic adjustment were found in the participants of both groups immediately following their respective group sessions, but there were only a few statistically significant differences between the two groups. Those who attended the psychoeducational session, however, reported significantly more satisfaction with the experience.

Adult↗

Cancer screening behaviors among Korean-American women.

The goals of this study were to evaluate breast and cervical cancer screening tests and to examine the correlates of cancer screening behaviors. A cross-sectional face-to-face survey of 438 Korean-American women residing in Maryland was conducted. About 50% of women age 18 and older had had a Pap smear and 46.6% of these women age 40 and older had had a mammogram in the past 2 years. In multiple logistic regression analyses, the strongest correlate of screening behaviors was having a regular medical checkup. Age and acculturation were found to be important correlates of cancer screening tests: Women less than 50 years of age were more likely to have cancer screening tests than those 50 years and older. English language proficiency was associated with having a mammogram and the proportion of life spent in the United States was associated with having a Pap smear. Employment interacted with marital status for a Pap smear, with those married and unemployed being less likely to have a Pap smear than women who were both married and employed. For strategies to increase cancer-screening tests among Korean-American women, we need to aim at developing culturally appropriate educational programs about cancer for less acculturated and recent immigrants.

Adult↗