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PubMed1991

Parental responses to consanguinity and genetic disease in Saudi Arabia.

In-depth interviews of 36 Saudi families whose children suffered from neuro-metabolic disorders were conducted at a specialist hospital in Riyadh in order to examine parental understanding of disease and attitudes towards future births and consanguineous marriages. Parents had difficulty accepting a genetic explanation for diseases that did not affect all children at the time of birth; they also expressed religious or folk beliefs to account for illness. Coping behaviours included denial and resignation to the situation, divorce and remarriage. Some families adopted a cautious approach to cousin marriages and future births; this was significantly related to their education level, but not to previous infant deaths. Awareness of medical facts brought little emotional comfort to parents but allowed for preventive measures through screening adult carriers and identifying affected infants. This study presents new material from Saudi Arabia to strengthen current awareness that the range of religious beliefs, social attitudes and reproductive behaviours adopted by families in a society undergoing rapid change is of direct relevance to health care.

Adaptation, Psychological↗
PubMed1993

Vasectomy as a reason for donor insemination.

Among 200 couples referred for counselling with a view to donor insemination (DI) were 21 whose request arose from an earlier vasectomy. This had been judged irreversible, apart from one case where the man had been sterilised for genetic reasons and therefore had not sought reversal. An overall incidence of 10.5% indicates that vasectomy may lead to fertility problems in the event of remarriage, which has become more common with an increasing divorce rate. All 21 husbands but only 3 wives had been previously married; 3 former wives had died, otherwise all previous marriages had ended in divorce. Most husbands were considerably older than their second wives, especially as compared with the majority of men in the larger series who were still in a first marriage. Their relative maturity may have helped them to respond more sensitively to their wives' maternal needs when they already had children of their own. During a follow-up interval of up to 8 years, 2 couples had separated after a brief relationship but 9 of the other 12 contacted had become parents by DI. The 3 remaining couples included a wife who at the latest report was 5 months pregnant, and 2 who were still pursuing treatment. Despite the low failure rate in this small series we should bear in mind that DI is not an ideal solution to the problem of male infertility, nor always even acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Patterns of sexual behaviour in a rural population in north-western Tanzania.

The HIV epidemic in sub-Saharan Africa has been characterised by the predominance of heterosexual transmission. Patterns of sexual behaviour have been implicated in the spread of the epidemic, but few quantitative data are available on sexual behaviour in rural populations in Africa. This paper reports data from a survey of 1117 adults aged 15-54 years selected randomly from twelve rural communities in Mwanza Region, Tanzania. Sexual debut occurred early, 50% of women and 46% of men reporting first sex before age 16. On average, women married 1.8 years and men 6.1 years after their sexual debut. In women, age at sexual debut appears to have increased over time, in parallel with an increase in age at first marriage. Men were generally married later, to women around five to ten years younger than themselves. Marital dissolution and remarriage were common in both sexes. Reported numbers of sexual partners were compared with those recorded in a population survey in Britain. More men reported 10 or more lifetime partners, or three or more partners in the past year, in rural Mwanza (48% and 29%) than in Britain (24% and 6%). Women reported fewer partners, and results were broadly similar to British data. Casual sex during the past year was reported by 53% of the men and 15% of the women, but only 2% of men reported sexual contact with bar girls or commercial sex workers. Only 20% of men and 3% of women had ever used a condom. Interventions are needed to reduce the high levels of sexual partner change and casual sex, and low levels of condom use, recorded in this rural population. Targeting of interventions to traditional "core groups" may be of limited value in rural areas, and additional strategies are needed, focusing particularly on teenagers who are at high risk of HIV and other sexually transmitted diseases.

Adolescent↗
PubMed2000

Living with infertility: experiences among Urban slum populations in Bangladesh.

This paper explores the perceived causes of infertility, treatment-seeking for infertility and the consequences of childlessness, particularly for women, among a predominantly Muslim population in urban slums of Dhaka in Bangladesh. In-depth interviews were conducted with 60 women and 60 men randomly selected from Urban Surveillance System clusters of the International Centre for Diarrhoeal Disease Research, Bangladesh. Case studies of 20 self-perceived infertile women who had previously participated in a study on the prevalence of sexually transmitted diseases and other reproductive tract infections were taken, and three traditional healers were interviewed as key informants. In both groups of respondents, the leading causes of infertility were perceived to be evil spirits and physiological defects in women and psychosexual problems and physiological defects in men. Herbalists and traditional healers were considered the leading treatment option for women, while for men it was remarriage, followed by herbalists and traditional healers. Childlessness was found to result in perceived role failure, with social and emotional consequences for both men and women, and often resulted in social stigmatisation of the couple, particularly of the woman. Infertility places women at risk of social and familial displacement, and women clearly bear the greatest burden of infertility. Successful programmes for dealing with infertility in Bangladesh need to include both appropriate and effective sources of treatment at community level and community-based interventions to demystify the causes of infertility, so that people know why infertility occurs in both men and women and and where best to seek care.

Adolescent↗
PubMed2000

The Copper-T 380A IUD: a ten-year alternative to female sterilisation in India.

High unmet need for limiting contraception persists in most states of India despite wide access to sterilisation. Qualitative evidence from a rural community in which child mortality is high and women's autonomy is low suggests that women may seek reversibility in a contraceptive even if they have finished childbearing. This paper describes the introduction of the Copper-T 380A--a contraceptive with an effective life span of ten years--as an alternative to female sterilisation in a rural area of the state of Rajasthan, in a clinic linked to an outreach programme. The intervention addressed women's apprehensions, ensured service standards and guaranteed women's right to have the Copper-T removed at will. Data on 216 insertions over 34 months revealed a preference for the Copper-T 380A among older women and women who had achieved desired family size, especially among tribal women. More than a quarter of the 30 removals in that period were for non-medical reasons, such as family opposition, child death or remarriage. As a long-term but reversible option, the Copper-T 380A allows women room to change their minds in relation to future childbearing until they have reached menopause. Including this option in family planning services can help to meet a portion of the unmet need for contraception among women not willing to choose sterilisation, while reducing dependence on doctors and expensive equipment.

Adolescent↗
PubMed2005

Family formation and dissolution in an Aegean island.

This paper explores family formation and dissolution in the Aegean island of Paros over the period 1894-1998. The examined issues are: trends in age at marriage, age gap between spouses, age differentials among different occupational groups, age at widowhood, remarriage, illegitimacy and bridal pregnancy. The main findings confirmed that certain characteristics of the 'Mediterranean' marriage pattern, such as low age at marriage for females, high for males and large age gap between spouses, were present in the study population up until the 1980s. The feature of the family cycle that has changed most dramatically over the examined period is age at widowhood, which has increased spectacularly owing to the impressive progress in adult, and especially maternal, mortality that took place in Greece in the post-war years.

Adult↗
PubMed2002

Defining the brain systems of lust, romantic attraction, and attachment.

Mammals and birds have evolved three primary, discrete, interrelated emotion-motivation systems in the brain for mating, reproduction, and parenting: lust, attraction, and male-female attachment. Each emotion-motivation system is associated with a specific constellation of neural correlates and a distinct behavioral repertoire. Lust evolved to initiate the mating process with any appropriate partner; attraction evolved to enable individuals to choose among and prefer specific mating partners, thereby conserving their mating time and energy; male-female attachment evolved to enable individuals to cooperate with a reproductive mate until species-specific parental duties have been completed. The evolution of these three emotion-motivation systems contribute to contemporary patterns of marriage, adultery, divorce, remarriage, stalking, homicide and other crimes of passion, and clinical depression due to romantic rejection. This article defines these three emotion-motivation systems. Then it discusses an ongoing project using functional magnetic resonance imaging of the brain to investigate the neural circuits associated with one of these emotion-motivation systems, romantic attraction.

Affect↗
PubMed1991

Family conflict and adolescent adjustment in intact, divorced, and blended families.

This study examined two contrasting views of how parental marital status relates to the long-term adjustment of children. The physical wholeness position views divorce and subsequent remarriage and the blending of families as salient explanatory variables that adversely affect children's later adjustment through the physical dissolution of the nuclear family; the psychological wholeness position views perceived current family conflict as the critical variable that influences adjustment, regardless of parental marital status. Results of analyses on White adolescents (N = 917) fail to support the physical wholeness position; rather, results support the psychological wholeness position. Adolescents' adjustment was related to level of perceived family conflict.

Adaptation, Psychological↗
PubMed1991

The lesbian family life cycle: a contextual approach.

A recent broadening of family life cycle theory to include the various family norms deriving from ethnic differences, single parenting, divorce, and remarriage has not extended to the lesbian family experience. The need to articulate a lesbian family life cycle is underscored here with particular attention to the specific challenges and coping mechanisms of this particular family experience.

Family↗
PubMed1998

Suicidal behavior in adolescents: stress and protection in different family contexts.

Recent suicidal behavior was reported on a questionnaire by 14% of 272 high school students. Two-thirds of the suicidal teenagers neither received help nor disclosed their self-harm to anyone. Depression and stress--especially family suicidality, feelings of violation, and sexuality--increased the risk, as did parental separation, divorce, and most dramatically, remarriage. Family cohesiveness helped alleviate the risk in the nonintact families.

Adolescent↗
PubMed1999

Free markets and the marriage market: structural adjustment, gender relations, and working conditions among Dominican women workers.

The relationship between economic conditions and marriage patterns in the Dominican Republic is analyzed using data collected in 1994 on women working in a free-trade zone. The author concludes that changes associated with structural adjustment appear to have contributed to a deterioration of the job market and a greater prevalence of female-headed households. It is shown that "structural adjustment increases the need for women to work, because of cuts in government programs, declining real wages, growing inflation, and a deterioration in male employment, which weakens the man's role as principal breadwinner and increases the importance and visibility of women's contribution to the household economy. This change in the gender composition of the labor force has encouraged some women to resist marriage and/or remarriage because the ¿marriage market' of eligible men willing and able to support a family has been reduced, contributing to greater marital instability."

Americas↗
PubMed1990

Turbulent dynamics in a XVIIth century population.

"A reconstruction of the population of the Pays de Caux [France] (1589-1700) yields the time series of a fertility behavior indicator....An attempt is made to explain this general temporal structure by using a simulation model based on the autoregulation model (the so-called European Marriage Pattern), putting into play a choice of the spouse function, a fertility function, modalities of marriage and remarriage, under the environmental forcing of the reconstructed mortality conditions. The correspondence between reconstruction and simulation turns out to be quite good....A second simulation with simulated mortality conditions shows a bifurcation point: as the mean frequency of crisis increases, the state of the system leaves the lower level and concentrates more and more in the higher level." (SUMMARY IN FRE)

Demography↗
PubMedDate not supplied

Third birth intentions and uncertainty in Canada.

Using data from the 1995 Canadian General Society Survey (GSS-95), we study the intention to have a third child among a sample of women and men who have already had two children (N = 505). Our results show that 15 per cent of the respondents intend to have a third child. Nearly 20 per cent of the respondents are uncertain about their fertility intentions. We found that the same factors that predict intentions also predict uncertainty, and that the effects of these predictors are remarkably similar. In particular, intentions and uncertainty generally decline with age, but increase with regular church attendance, remarriage, and being Catholic. Unlike earlier studies, we found that the sex of previous children has virtually no impact on third-birth intentions or uncertainty.

Adolescent↗
PubMed2003

Modeling intraindividual change in personality traits: findings from the normative aging study.

To advance an intraindividual life-span approach to the issue of stability and change, we studied personality trait trajectories in adulthood. Growth curves for extraversion and neuroticism were estimated for over 1600 men (initially aged 43-91) in the Normative Aging Study, who were followed over 12 years. We found significant individual differences in intraindividual change for both traits, as well as different trajectories for extraversion and neuroticism. The overall extraversion trajectory was best defined by a linear model, but neuroticism was characterized by quadratic decline with age. We then considered several variables as predictors of individual differences around these overall trajectories. Birth cohort, marriage or remarriage, death of spouse, and memory complaints were all significant predictors, explaining variability in both level and rate of personality trait change. These findings suggest that there is a good deal of variability in personality trajectories, and that some of this variability can be explained by birth cohort as well as by age-graded life events.

Adult↗
PubMed2006

Cohabitation among older adults: a national portrait.

OBJECTIVE: Older adults are increasingly likely to experience cohabitation, or living together unmarried in an intimate, heterosexual union. In order to begin building a conceptual framework, we provide a descriptive portrait of older adult cohabitors, emphasizing how they compare to older remarrieds and unpartnereds. METHODS: We used data from both Census 2000 and the 1998 Health and Retirement Study ( HRS; Health and Retirement Study, 1998) to estimate the size and composition of the cohabiting population aged 51 and older. Also, using HRS data, we estimated multinomial logistic regression models to identify the correlates associated with cohabitation and remarriage (vs being unpartnered) among women and men who were previously married. RESULT: More than 1 million older adults, composing 4% of the unmarried population, currently cohabit. About 90% of these individuals were previously married. We identify significant differences among cohabitors, remarrieds, and unpartnereds across several dimensions, including sociodemographic characteristics, economic resources, physical health, and social relationships. Cohabitors appear to be more disadvantaged than remarrieds, and this is especially evident for women. DISCUSSION: Older cohabitors differ from individuals of other marital statuses, and therefore future work on marital status should explicitly incorporate cohabitation.

Activities of Daily Living↗
PubMed2004

Effects of marital transitions on changes in dietary and other health behaviours in US women.

BACKGROUND: Previous studies have indicated that married people have lower mortality and are generally healthier. Most previous studies have been cross-sectional and few studies investigated the effect of marital transition on health. With a prospective design and repeated measures of variables, we sought to analyse the temporal relation between marital transition and change in health behaviours. METHODS: We followed up 80 944 women aged 46-71 for 4 years (1992-1996). All information was self-reported. We used multivariate-adjusted linear and logistic regression models to examine the impact of changes in marital status on concomitant changes in health behaviours, controlling for potential confounders and baseline health behaviours. RESULTS: Compared with women who remained married, women who divorced/widowed had body mass index (BMI) decreases of 0.65 kg/m(2) (P < 0.001) and 0.44 kg/m(2) (P < 0.001), respectively. Compared with women who remained unmarried, women who remarried had an increase in mean BMI of 0.41 kg/m(2) (P < 0.001). Women who divorced increased physical activity by 1.23 metabolic equivalent hours (MET)/week (P = 0.07) compared with women who stayed married. Among non-smokers and past smokers, women who divorced/widowed had more than a twofold increased risk of relapsing/starting smoking (OR = 2.47, 95% CI: 1.56, 3.89; OR = 2.08, 95% CI: 1.56, 2.76, respectively) than women who stayed married. Divorced and widowed women had decreased vegetable intake relative to women who stayed married (-2.93 servings/week [P < 0.001] and -1.67 servings/week [P < 0.001], respectively). CONCLUSIONS: These patterns suggest both health-damaging and health-promoting changes accompanying divorce and widowhood, and generally health-promoting changes following remarriage.

Aged↗
PubMed2004

Impact of the HIV epidemic on population and household structure: the dynamics and evidence to date.

BACKGROUND: HIV is contracted most frequently at birth and during early adulthood. The epidemic may thus impact the demographic structure and the household structure of affected populations. METHODS: This paper reviews earlier evidence of such an impact, uses demographic theory to anticipate its changes over time, and reviews the most recent evidence for indications of these changes. RESULTS: Modest increases in the male : female ratio are beginning to show within certain age groups only (approximately 15% among 25-34 year olds). Similarly sized increases in the proportion of 15-29 year olds relative to 30-54 year olds are observed in some age pyramids. These 'youth bulges' are expected to fade out, whereas an aging effect phases in with the fertility impact of the epidemic. In the longer run, the size of all age groups will be reduced, but relatively less so for middle-aged adults. Proportions of orphans and widows have increased in the most affected countries. Fewer remarriage probabilities for widows were observed. Resulting increases in the proportion of female-headed households should only be temporary, as female mortality is catching up with male mortality. The number of double orphans is beginning to increase, but overall, orphans continue to live predominantly with a family member, most often the grandparents if not with the surviving parent. CONCLUSION: To date, the epidemic's impact on the population and household structure has been limited by demographic (aging) and social (adaptive movements of kin across households) processes that contribute to diffuse the epidemic throughout the entire population and all households.

Adolescent↗
PubMed1993

Psychosocial risks for major depression in late adolescence: a longitudinal community study.

OBJECTIVE: An ongoing 14-year longitudinal study examined psychosocial antecedents of major depression in late adolescence in a community population. METHOD: Subjects were 385 adolescents followed between the ages of 5 and 18 years. Early health, familial, behavior, academic, and environmental risks for major depression were identified using data collected at ages 5, 9, 15, and 18 years. At age 18, a lifetime diagnosis of major depression was assessed using the NIMH Diagnostic Interview Schedule (DIS-III-R). RESULTS: For males, neonatal health problems, dependence problems at age 5 years, perceived unpopularity and poorer perceptions of their role in the family at age 9 years, remarriage of a parent, early family discord, and anxiety at age 15 years significantly increased the risk of developing major depression. Females with major depression, compared with nondepressed females, had older parents and came from larger families, and at age 9 years had greater perceived unpopularity and anxiety, lower self-esteem, and poorer perceptions of their role in the family. Depressed females also reported more stressful life events, including death of parent and pregnancy. CONCLUSIONS: Underscoring the importance of early psychosocial factors in the later development of major depression and pointing to specific risks, our findings can aid in developing strategies for prevention and early intervention.

Achievement↗