WorldWideScience

Sample records for international family adult

  1. International Adoptees as Teens and Young Adults: Family and Child Function

    Science.gov (United States)

    Matthews, Jessica A. K.; Tirella, Linda G.; Germann, Emma S.; Miller, Laurie C.

    2016-01-01

    Many of the >339,000 international adoptees arriving in the USA during the last 25 years are now teenagers and young adults (YA). Information about their long-term social integration, school performance, and self-esteem is incomplete. Moreover, the relation of these outcomes to facets of family function is incompletely understood. We…

  2. Common mental disorders among adult members of 'left-behind' international migrant worker families in Sri Lanka.

    Science.gov (United States)

    Siriwardhana, Chesmal; Wickramage, Kolitha; Siribaddana, Sisira; Vidanapathirana, Puwalani; Jayasekara, Buddhini; Weerawarna, Sulochana; Pannala, Gayani; Adikari, Anushka; Jayaweera, Kaushalya; Pieris, Sharika; Sumathipala, Athula

    2015-03-28

    Nearly one-in-ten Sri Lankans are employed abroad as International migrant workers (IMW). Very little is known about the mental health of adult members in families left-behind. This study aimed to explore the impact of economic migration on mental health (common mental disorders) of left-behind families in Sri Lanka. A cross-sectional survey using multistage sampling was conducted in six districts (representing 62% of outbound IMW population) of Sri Lanka. Spouses and non-spouse caregivers (those providing substantial care for children) from families of economic migrants were recruited. Adult mental health was measured using the Patient Health Questionnaire. Demographic, socio-economic, migration-specific and health utilization information were gathered. A total of 410 IMW families were recruited (response rate: 95.1%). Both spouse and a non-spouse caregiver were recruited for 55 families with a total of 277 spouses and 188 caregivers included. Poor general health, current diagnosed illness and healthcare visit frequency was higher in the non-spouse caregiver group. Overall prevalence of common mental disorder (CMD; Depression, somatoform disorder, anxiety) was 20.7% (95%CI 16.9-24.3) with 14.4% (95%CI 10.3-18.6) among spouses and 29.8% (95%CI 23.2-36.4) among non-spouse caregivers. Prevalence of depression (25.5%; 95%CI 19.2-31.8) and somatoform disorder 11.7% (95%CI 7.0-16.3) was higher in non-spouse caregiver group. When adjusted for age and gender, non-returning IMW in family, primary education and low in-bound remittance frequency was associated with CMD for spouses while no education, poor general health and increased healthcare visits was significantly associated in the non-spouse caregiver group. To our knowledge, this is one of the first studies to explore specific mental health outcomes among adult left-behind family members of IMW through standardized diagnostic instruments in Sri Lanka and in South Asian region. Negative impact of economic migration is

  3. Internationalism in Early Adult Education.

    Science.gov (United States)

    Keane, Patrick

    1985-01-01

    Explores the nature and scope of internationalism in early 19th century adult education, using as a context the lyceums and mechanics' institutes of Britain and North America. The contacts involved newspaper and journal accounts, the personal advocacy of former members, written advice from promoters and administrators, and the contributions of…

  4. Adolescent Family Context and Adult Identity Formation

    Science.gov (United States)

    Benson, Janel E.; Johnson, Monica Kirkpatrick

    2009-01-01

    This study examines the links between adolescent family context and coming to see oneself as an adult. Using data from the National Longitudinal Study of Adolescent Health, the authors investigate how adolescent family structure, resources, and processes together influence adult identity and whether they do so similarly for men and women. The…

  5. Internal migration and income of immigrant families

    OpenAIRE

    Rashid, Saman

    2004-01-01

    Using a longitudinal dataset from the years 1995 and 2000, respectively, this study examines whether migration within the host country of Sweden generates higher total annual income for (two-earner) immigrant families. The empirical findings indicate that internal migration generates a positive outcome in terms of higher family income for newly arrived refugee-immigrant families. Further, with the length of residence in the host country, the monetary gain accruing from internal migration decr...

  6. Internationalism and Our "Strenuous Family."

    Science.gov (United States)

    Ashworth, Mary

    1991-01-01

    Explores the concept of internationalism within the context of teaching English as a Second Language, arguing that, in spite of diverse perspectives, instructors can unite internationally to advocate literacy and language education, protect multiculturalism, and support international goals. (16 references) (CB)

  7. Family characteristics of internal migration in China.

    Science.gov (United States)

    Rowland, D T

    1992-03-01

    Data from the 1986 survey of migration conducted by the Chinese Academy of Social Sciences (CASS) were used to examine family characteristics of internal migrants to urban areas in China. The influence of the family either directly or indirectly is considered as part of life cycle events. .2% of households in 74 cities and towns were surveyed (100,267 persons). Data were analyzed 1) for persons who moved within 10 years of the survey (47%--17,890 out of 38,104 in-migrants), and 2) by last move by age regardless of when (72% between 1966-86). The literature and conditions in China strongly support that family welfare is likely to be a significant underlying influence on patterns and selectivity of migration in China. The CASS survey reveals that the most movers were from nuclear families aged 25-44 years, followed by stem families (a couple plus 1 or more parents). 6 factors are identified for sustaining co-residence within generations. Migrations during 1977-86 showed that 41% of males aged 20-24 years had moved at least once (18% were married), while for females the figure was 25% (50% were married). 56% of males moving at ages 25-29 years were married, and 90% of migrant males aged 30-34 years were married. 78% of married females aged 25-29 years and 94% of those aged 30-34 years moved. 23% of widowed females aged 50-54 years were in-migrants, and 69% were aged 65 years and widowed. The opportunity for 2- and 3- generation households is expected t decline over the next 50 years as the population ages and becomes larger than the supporting population. 44% of young-old women (75-74 years) with no children and 25-33% of young-old women total had moved within the last 10 years. 43% of women aged 75 years or older with 5 or more children moved within 10 years, while only 24% with no children had. Women aged 35-54 years had low rates of movement with high parity, while those aged 25-44 with 1 or no children had higher rates of movement. Parity is increasingly

  8. Funding for international family planning attacked.

    Science.gov (United States)

    Kaeser, L

    1997-08-01

    US funding for foreign assistance has been jeopardized in recent years in the context of dwindling public support for foreign aid. To stymie the provision of international family planning program assistance and services overseas, Congressional opponents of family planning and abortion are offering amendments to foreign aid legislation at every possible opportunity. State Department reauthorization legislation is the current target of family planning opponents' efforts. Reauthorization is the process by which Congress indicates its ongoing support for a program, makes any necessary changes, and sets new funding ceilings. The global gag rule joined UNFPA funding cuts on the 1997 State Department reauthorization bill, H.R. 1757, which passed the House of Representatives in early June. If successfully appended to the State Department bill, the gag rule would prevent the US from funding any organization in a developing country which provides legal abortion services or communicates with its government on abortion-related policy, regardless of whether that organization used its own non-US funds. These restrictions and cuts to international family planning program assistance could adversely affect family planning programs, leading to less contraceptive use and higher rates of abortion, maternal morbidity, and maternal mortality. President Bill Clinton has promised to veto the bill if both houses of Congress accept the restrictions. These issues will probably arise on the annual appropriations legislation which funds US operations overseas.

  9. Parent Cortisol and Family Relatedness Predict Anxious Behavior in Emerging Adults

    Science.gov (United States)

    Johnson, Vanessa Kahen; Gans, Susan E.

    2016-01-01

    Emerging adult cortisol response during family interaction predicts change in EA anxious behavior during the transition to college (Gans & Johnson, in press). In the present study, we take an additional step toward integrating family systems research and physiology by including assessment of parent physiology. We collect salivary cortisol from parents and emerging-adults during triadic family interaction. Emerging adults (N = 101) between the ages of 17 and 19 were assessed at three time points across their first college year: the summer before college, fall and spring semesters. Two parents accompanied the emerging adult child to the summer assessment; all family members provided four saliva samples each at 20-minute intervals. Later assessments of emerging adults included measures of internalizing behaviors. Parents’ cortisol secretion patterns during family interaction predict their emerging adult child’s cortisol secretion pattern, parent perceptions of the family environment, and emerging adult children’s internalizing behavior during the college transition. Different patterns of results emerged for mothers’ and fathers’ cortisol response to family interaction, and for families with sons or with daughters. The approach taken by this study provides a first step toward understanding how interrelationships among elements of physiology and family functioning contribute to adjustment during major life transitions. PMID:27536860

  10. Who counts as family? Family typologies, family support, and family undermining among young adult gay and bisexual men.

    Science.gov (United States)

    Soler, Jorge H; Caldwell, Cleopatra H; Córdova, David; Harper, Gary; Bauermeister, José A

    2018-06-01

    Gay and bisexual men may form chosen families in addition to or in place of families of origin. However, the characteristics of these diverse families remain largely unexamined in the quantitative literature. The purpose of this study was to develop a family typology based on responses from a racially and ethnically diverse sample of young adult gay and bisexual men (YGBM) recruited from the Detroit Metropolitan Area (N=350; 18-29 years old). To explore the role of family, we then examined family social support and social undermining in relation to YGBM psychological distress within different family types. A series of multivariate regressions were used to examine associations between family social support and social undermining with depression and anxiety outcomes. The majority (88%) of YGBM included family of origin in their definitions of family and 63% indicated having chosen families. Associations between family social processes and psychological outcomes varied by type of family, suggesting that family composition shapes how perceptions of support and undermining relate to experiencing symptoms of depression and anxiety. Chosen families play a prominent role in the lives of YGBM and should not be overlooked in family research. Findings also highlight the importance of examining co-occurring family social support and social stress processes to further address psychological distress symptoms among YGBM.

  11. Mental Wellbeing of Family Members of Autistic Adults

    Science.gov (United States)

    Herrema, Renske; Garland, Deborah; Osborne, Malcolm; Freeston, Mark; Honey, Emma; Rodgers, Jacqui

    2017-01-01

    Family members are often the primary caregiver for autistic adults and this responsibility may impact on the carer's wellbeing and quality of life. 109 family members of autistic adults completed an online survey assessing their wellbeing relating to their caring role for their autistic relative. Family members who were supporting an autistic…

  12. Work-Family Planning Attitudes among Emerging Adults

    Science.gov (United States)

    Basuil, Dynah A.; Casper, Wendy J.

    2012-01-01

    Using social learning theory as a framework, we explore two sets of antecedents to work and family role planning attitudes among emerging adults: their work-family balance self-efficacy and their perceptions of their parents' work-to-family conflict. A total of 187 college students completed a questionnaire concerning their work-family balance…

  13. The Lived Experiences of International Students Who's Family Remains at Home

    Science.gov (United States)

    Harvey, Theresa; Robinson, Carolyn; Welch, Anthony

    2017-01-01

    The significant increase of international students, who leave their family at home, to study abroad, especially in the discipline of nursing, has implications for educational practice. This study's aim was to explore adult international students' experiences of leaving spouse and children--for further education overseas. A descriptive…

  14. The epidemiology of family meals among Ohio's adults.

    Science.gov (United States)

    Tumin, Rachel; Anderson, Sarah E

    2015-06-01

    The epidemiology of family meals among adults at a population level is poorly characterized and whether living with children impacts this health behaviour is uncertain. We determined the prevalence of family meals among US adults in a mid-western state whose families did and did not include minor children and described how it varied by sociodemographic characteristics. The cross-sectional 2012 Ohio Medicaid Assessment Survey is representative of Ohio adults and included questions on their sociodemographic characteristics and the frequency with which they eat family meals at home. Trained interviewers administered landline and cell phone surveys to adults sampled from Ohio's non-institutionalized population. We analysed data from 5766 adults living with minor children and 8291 adults not living alone or with children. The prevalence of family meals was similar for adults who did and did not live with minor children: 47 % (95 % CI 46, 49 %) of adults living with and 51 % (95 % CI 50, 53 %) of adults living without children reported eating family meals on most (six or seven) days of the week. Family meal frequency varied by race/ethnicity, marital and employment status in both groups. Non-Hispanic African-American adults, those who were not married and those who were employed ate family meals less often. Adults in Ohio frequently shared meals with their family and family meal frequency was not strongly related to living with children. Broadening the scope of future studies to include adults who are not parents could enhance our understanding of the potential health benefits of sharing meals.

  15. International Migration and its Effects on Family

    Directory of Open Access Journals (Sweden)

    Cornel Constantinescu

    2008-03-01

    Full Text Available The crises period that still cross Romania explain, between others, the apparition and development of international migration, after 1990. In a world marked by globalization, migration can not disappear, contrary, it grows bigger ant it remains an interesting subject in future. A study about migration consequences on family, specially on children’s personality left in the country, is justified because migration is a present phenomena in Romanian space at the beginning of the XXIth century. We try to analyse the effects of this phenomenon on family. Related to these goal we offer the conclusions obtained from a research realized in Campulung Muscel municipality, Arges county, on a lot of pupils that have parents left in foreign countries and the results to the investigation made in Pitesti municipality. The research showed that it is a relationship between children’s marks at school and parent’s leaving; children’s perceptions on parent’s leaving; identifies school’s interest level in diminution of the low school performance effects caused by this socio-economical phenomena.

  16. External and internal geometry of European adults.

    Science.gov (United States)

    Bertrand, Samuel; Skalli, Wafa; Delacherie, Laurent; Bonneau, Dominique; Kalifa, Gabriel; Mitton, David

    2006-12-15

    The primary objective of the study was to bring a deeper knowledge of the human anthropometry, investigating the external and internal body geometry of small women, mid-sized men and tall men. Sixty-four healthy European adults were recruited. External measurements were performed using classical anthropometric instruments. Internal measurements of the trunk bones were performed using a stereo-radiographic 3D reconstruction technique. Besides the original procedure presented in this paper for performing in vivo geometrical data acquisition on numerous volunteers, this study provides an extensive description of both external and internal (trunk skeleton) human body geometry for three morphotypes. Moreover, this study proposes a global external and internal geometrical description of 5th female 50th male and 95th male percentile subjects. This study resulted in a unique geometrical database enabling improvement for numerical models of the human body for crash test simulation and offering numerous possibilities in the anthropometry field.

  17. Differences between Irish and Australian psychiatric nurses' family-focused practice in adult mental health services

    LENUS (Irish Health Repository)

    Grant, Anne

    2016-04-01

    Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

  18. Family Influences on the Career Development of Young Adults.

    Science.gov (United States)

    Splete, Howard; Freeman-George, Ann

    1985-01-01

    This article (1) reviews family influences on career development (geographic location, genetic inheritance, family background, socioeconomic status, family composition, parenting style, parental work-related attitudes) and (2) suggests counselor interventions to aid young adults in becoming autonomous in their career development (e.g., review…

  19. The Corporate Social Responsibility of Family Businesses: An International Approach

    OpenAIRE

    Gérard Hirigoyen; Thierry Poulain-Rehm

    2014-01-01

    International audience; This study analyzes the links between listed family businesses and social responsibility. On the theoretical level, it establishes a relationship between socioemotional wealth, proactive stakeholder engagement, and the social responsibility of family businesses. On a practical level, our results (obtained from a sample of 363 companies) show that family businesses do not differ from non-family businesses in many dimensions of social responsibility. Moreover, family bus...

  20. Family Comes First! : Relationships with family and friends in Italian emerging adults

    NARCIS (Netherlands)

    Crocetti, Elisabetta; Meeus, W.H.J.

    2014-01-01

    We conducted two studies to examine relationships with family and friends in Italian emerging adults, paying attention to the potential moderating role of gender and occupational status. In Study I, we aimed at capturing emerging adults' perspective on interactions with both family and friends by

  1. "Family Comes First!" Relationships with family and friends in Italian emerging adults

    NARCIS (Netherlands)

    Crocetti, Elisabetta; Meeus, Wim

    2014-01-01

    We conducted two studies to examine relationships with family and friends in Italian emerging adults, paying attention to the potential moderating role of gender and occupational status. In Study I, we aimed at capturing emerging adults' perspective on interactions with both family and friends by

  2. The role of a family for internal dose formation in rural community

    International Nuclear Information System (INIS)

    Vlasova, N.V.; Rozhko, A.V.; Stavrov, V.V.

    2008-01-01

    Full text: Despite correct evaluation of agricultural land contamination of a settlement and the activity of foodstuffs, it is impossible to explain dose formation in rural community. And without this knowledge it is impossible to estimate correctly decision-making. The dose formation research was provided earlier in rural community based on the concept describing that the individual with his personal characteristics, social and economic statuses during his practical activity interacting with the contaminated environment, actively contributes to dose formation. Such approach only partly allows revealing dose formation mechanisms though there are some unclear issues: for example, high doses at some children. At the same time children, as well as all residents are the members of families. Direct consumption of food stuffs is provided within a family. It is preceded with the formation of psycho-emotional perception of radiation danger factor. There have been used the data of internal doses of the inhabitants obtained by the results of WBC-measurements. Simultaneously with performing of WBC measurements by interviewing of adult members of a family there was revealed the frequency of visits to forest and consumption rate of its 'gifts'. The method of a family analysis of internal dose formation is the classification of families by set of the informative attributes describing dose formation in a family such as an average internal dose at a member of a family; family total dose; the description of a family 'contact' with a forest; the number of family members; the number of children in a family; average age and the educational level of adult members of a family; gender and occupation of the head of a family; age and education of the head of a family. As a result of multivariate classification of families in the settlement there was obtained 10 different classes providing complete imagination about a variety of families' types. The average doses in classes essentially

  3. The Chinese family-centered care survey for adult intensive care unit: A psychometric study.

    Science.gov (United States)

    Wang, Wen-Ling; Feng, Jui-Ying; Wang, Chi-Jen; Chen, Jing-Huei

    2016-02-01

    This study aimed to develop a family-centered care survey for Chinese adult intensive care units and to establish the survey's psychometric properties. Family-centered care (FCC) is widely recognized as an ideal model of care. Few studies have explored FCC perceptions among family members of adult critical care patients in Asian countries, and no Chinese FCC measurement has been developed. An English version of the 3-factor family-centered care survey for adult intensive care units (FCCS-AICU) was translated into Chinese using a modified back translation procedure. Based on the literature review, two additional concepts, information and empowerment, were added to the Chinese FCCS-AICU. The psychometric properties of the Chinese FCCS-AICU were determined with 249 family members from a medical center in Taiwan and were tested for construct and convergent validity, and internal consistency. Both the monolingual and bilingual equivalence tests of the English and Chinese versions of the 3-factor FCCS-AICU were supported. Exploratory factor analysis supported the 5-factor structure of the Chinese FCCS-AICU with a total explained variance of 58.34%. The Chinese FCCS-AICU was correlated with the Chinese Critical Care Family Needs Inventory. Internal consistency, determined by Cronbach's α, for the overall scale was .94. The Chinese FCCS-AICU is a valid and reliable tool for measuring perceptions of FCC by family members of adult intensive care patients within Chinese-speaking communities. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Discussions about Racial and Ethnic Differences in Internationally Adoptive Families: Links with Family Engagement, Warmth, & Control.

    Science.gov (United States)

    Anderson, Kayla N; Rueter, Martha A; Lee, Richard M

    Discussions about racial and ethnic differences may allow international, transracial adoptive families to construct multiracial and/or multiethnic family identities. However, little is known about the ways family communication influences how discussions about racial and ethnic differences occur. This study examined associations between observed family communication constructs, including engagement, warmth, and control, and how adoptive families discuss racial and ethnic differences using a sample of families with adolescent-aged children adopted internationally from South Korea ( N = 111 families, 222 adolescents). Using data collected during mid-adolescence and again during late adolescence, higher levels of maternal control and positive adolescent engagement were independently associated with a greater likelihood that family members acknowledged the importance of racial and ethnic differences and constructed a multiracial and/or multiethnic family identity. Adolescent engagement was also related to a greater likelihood that family members disagreed about the importance of racial and ethnic differences, and did not build a cohesive identity about differences.

  5. Creating grander families: older adults adopting younger kin and nonkin.

    Science.gov (United States)

    Hinterlong, James; Ryan, Scott

    2008-08-01

    There is a dearth of research on older adoptive parents caring for minor children, despite a growing number of such adoptions finalized each year. This study offers a large-scale investigation of adoptive families headed by older parents. We describe these families and explore how preadoptive kinship between the adoptive parent and the child impacts adoption outcomes. We analyze data from kin (n = 98) and nonkin (n = 310) adoptive families headed by adults aged 60 years and older. We find that older kin adoptive families are smaller, report lower income, and include adoptive mothers with less formal education. Children in these families had less severe needs for special care at the time of placement. Although kin and nonkin older parents offer similar assessments of their parent-child relationships, kin adopters indicate a greater willingness to adopt the same child again and yet report less positive current family functioning. Multivariate regression analyses reveal that preadoptive kinship predicts more negative parental assessment of the adoption's impact on the family and less positive family functioning net of other parent, family, and child characteristics. Externalizing behavior by the child (e.g., delinquency or aggression) is the strongest predictor of deleterious outcomes for both groups. Kin adoption by older adults creates new families under strain but does not reduce parental commitment to the child. We conclude that older adults serve as effective adoptive parents but would benefit from preadoption and postadoption services to assist them in preparing for and positively addressing the challenging behaviors exhibited by adopted children.

  6. Perceived Social Support from Friends and Family and Psychosocial Functioning in Bisexual Young Adult College Students

    Science.gov (United States)

    Sheets, Raymond L., Jr.; Mohr, Jonathan J.

    2009-01-01

    In this study, the authors investigated the degree to which perceived social support was associated with depression, life satisfaction, and internalized binegativity in a sample of 210 bisexual young adult college students. Two types of social support (general and sexuality specific) and 2 sources of social support (family and friends) were…

  7. Role of the family doctor in the management of adults with obesity: a scoping review

    NARCIS (Netherlands)

    Sturgiss, E.A.; Elmitt, N.; Haelser, E.; Weel, C. van; Douglas, K.A.

    2018-01-01

    OBJECTIVES: Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute

  8. Health, family strains, dependency, and life satisfaction of older adults.

    Science.gov (United States)

    Chokkanathan, Srinivasan; Mohanty, Jayashree

    2017-07-01

    Using stress process theory and structural equation modelling, this study investigated the complex relationship between health status, family strain, dependency, and the life satisfaction of rural older adults with reported functional impairments in India. Data were extracted from a large-scale study of 903 randomly selected adults aged 61 years and older from 30 rural clusters of India. The sample for this study was confined to 653 older adults who reported functional impairments. Structural equation modelling showed that poor health status indirectly lowered the life satisfaction of older adults through family strains. Moreover, poor health status also indirectly influenced life satisfaction through dependency and family strain (poor health→dependency→family strains→life satisfaction). The findings indicate that for professionals who deal with the health of older adults, exploring relationship strains and dependency is vital to the assessment and intervention of subjective wellbeing. Inter-sectoral coordination and communication between healthcare and social service agencies might facilitate effective management of health problems among older adults. Moreover, taking family strains and dependency into account when caring for older adults with health problems is critical to help improve their quality of life and maintain their wellbeing. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Branch migration and the international dispersal of families.

    Science.gov (United States)

    Parr, N; Lucas, D; Mok, M

    2000-01-01

    This paper discusses the dispersal of facilities where family members migrate to different destination countries. Terminology for internationally dispersed families is proposed, and the term branch migration is suggested for the migration of related people from the same source country to different destination countries. Data from two 1993 surveys of senior secondary students show that 22% of Sydney students and 20% of Hong Kong students have relatives in two or more other countries. The data suggest that many Asian migrant families have branched between the US, Canada, Australia and other migrant-receiving nations. The causes and implications of the international dispersal of families are discussed.

  10. The Role of Stress Exposure and Family Functioning in Internalizing Outcomes of Urban Families.

    Science.gov (United States)

    Sheidow, Ashli J; Henry, David B; Tolan, Patrick H; Strachan, Martha K

    2014-11-01

    Although research suggests that stress exposure and family functioning are associated with internalizing problems in adolescents and caregivers, surprisingly few studies have investigated the mechanisms that underlie this association. To determine whether family functioning buffers the development of internalizing problems in stress-exposed families, we assessed the relation between stress exposure, family functioning, and internalizing symptoms among a large sample of inner-city male youth and their caregivers living in poverty across five waves of data collection. We hypothesized that stress exposure and family functioning would predict development of subsequent youth and caregiver internalizing problems and that family functioning would moderate this relation, with higher functioning families demonstrating greater resiliency to stress exposure. We used a longitudinal, prospective design to evaluate whether family functioning (assessed at waves one through four) activated or buffered the effects of stress exposure (assessed at wave one) on subsequent internalizing symptoms (assessed at waves four and five). Stress from Developmental Transitions and family functioning were significant predictors of depressive symptoms and anxiety in youth; however, family functioning did not moderate the relation. Family functioning mediated the relation between stress from Daily Hassles and internalizing outcomes suggesting that poor parenting practices, low structure, and low emotional cohesion activate depression and anxiety in youth exposed to chronic and frequent everyday stressors. Surprisingly, only family functioning predicted depressive symptoms in caregivers. Results validate the use of a comprehensive, multi-informant assessment of stress when investigating internalizing outcomes in youth and support using family-based interventions in the treatment and prevention of internalizing.

  11. Familial risk and sibling mentalization: Links with preschoolers' internalizing problems.

    Science.gov (United States)

    Rodrigues, Michelle; Binnoon-Erez, Noam; Prime, Heather; Perlman, Michal; Jenkins, Jennifer M

    2017-09-01

    The current study explored whether older sibling mentalization moderated the relationship between familial risk for internalizing symptoms and the development of future internalizing problems in the younger siblings, referred to as target children. Data were collected on 397 older siblings at Time 1 (T1) when target children were newborn and their older siblings were on average 2.61 years old (SD = .75). Target children were on average 1.60 years old at Time 2 (T2). Internalizing problems were assessed via mother and partner reports. Familial risk was operationalized as the average of all older siblings' level of internalizing problems. Older sibling mentalization, indexed by internal state talk and reasoning, was observed and coded during a sibling pretend-play interaction at T2. Results revealed a significant interaction between familial risk of internalizing problems and older siblings' mentalizing abilities, showing that familial risk was related to target children's internalizing problems in the absence of sibling mentalization. Familial risk was not associated with target children's internalizing problems when siblings demonstrated mentalizing abilities. Findings support the need to consider sibling mentalization as a protective factor for children's internalizing problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Mental Wellbeing of Family Members of Autistic Adults.

    Science.gov (United States)

    Herrema, Renske; Garland, Deborah; Osborne, Malcolm; Freeston, Mark; Honey, Emma; Rodgers, Jacqui

    2017-11-01

    Family members are often the primary caregiver for autistic adults and this responsibility may impact on the carer's wellbeing and quality of life. 109 family members of autistic adults completed an online survey assessing their wellbeing relating to their caring role for their autistic relative. Family members who were supporting an autistic relative with co-occurring mental health difficulties and who they reported as unprepared for the future, self-reported higher levels of worry, depression, anxiety and stress, and poorer quality of life. These findings emphasise the importance of support for family members of autistic adults, whether through external services to support their relative or individual mental health support for the carer.

  13. International Population Assistance and Family Planning Programs: Issues for Congress

    National Research Council Canada - National Science Library

    Nowels, Larry; Veillette, Connie

    2006-01-01

    .... international family planning programs. In 1984, controversy arose over U.S. population aid policy when the Reagan Administration introduced restrictions, which became known as the "Mexico City policy...

  14. International Population Assistance and Family Planning Programs: Issues for Congress

    National Research Council Canada - National Science Library

    Blanchfield, Luisa

    2008-01-01

    .... international family planning programs. In 1984, controversy arose over U.S. population aid policy when the Reagan Administration introduced restrictions, which became known as the "Mexico City policy...

  15. Role of the family doctor in the management of adults with obesity: a scoping review

    Science.gov (United States)

    Elmitt, Nicholas; Haelser, Emily; Douglas, Kirsty A

    2018-01-01

    Objectives Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute methodology. Setting Primary care. Adult patients. Included papers Peer-reviewed and grey literature with the keywords obesity, primary care and family doctors. All literature published up to September 2015. 3294 non-duplicate papers were identified and 225 articles included after full-text review. Primary and secondary outcome measures Data were extracted on the family doctors’ involvement in different aspects of management, and whether whole person and person-centred care were explicitly mentioned. Results 110 papers described interventions in primary care and family doctors were always involved in diagnosing obesity and often in recruitment of participants. A clear description of the provider involved in an intervention was often lacking. It was difficult to determine if interventions took account of whole person and person-centredness. Most opinion papers and clinical overviews described an extensive role for the family doctor in management; in contrast, research on current practices depicted obesity as undermanaged by family doctors. International guidelines varied in their description of the role of the family doctor with a more extensive role suggested by guidelines from family medicine organisations. Conclusions There is a disconnect between how family doctors are involved in primary care interventions, the message in clinical overviews and opinion papers, and observed current practice of family doctors. The role of family doctors in international guidelines for obesity may reflect the strength of primary care in the originating health system. Reporting of primary care interventions could be improved by enhanced descriptions of the providers involved and explanation

  16. Network ties in the international opportunity recognition of family SMEs

    OpenAIRE

    Kontinen, Tanja; Ojala, Arto

    2011-01-01

    The importance of network ties is emphasized in the current literature on opportunity recognition. However, it is unclear how firms with limited bridging networks, such as family SMEs, recognize international opportunities through their network ties. In this case study we found that in gaining foreign market entry, those family SMEs that lack existing network ties recognize opportunities through weak ties formed in international exhibitions. The findings also indicate that rather than being p...

  17. "Families" in International Context: Comparing Institutional Effects across Western Societies

    Science.gov (United States)

    Cooke, Lynn Prince; Baxter, Janeen

    2010-01-01

    We review comparative evidence of institutional effects on families in Western societies. We focus on 2 key aspects of family life: gendered divisions of labor and people's transitions into, within, and out of relationships. Many individual-level models assume the effects are robust across countries. The international evidence over the past decade…

  18. [Effects of Home Care Services Use by Older Adults on Family Caregiver Distress].

    Science.gov (United States)

    Kim, Jiyeon; Kim, Hongsoo

    2016-12-01

    The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

  19. Perceptions of Family Alcohol Use in a Young Adult Sample

    OpenAIRE

    Serafini, Kelly A.; Stewart, David G.

    2015-01-01

    Perceptions of family alcohol use have been linked to adolescent alcohol use behaviors, yet there have been no studies that have assessed this relationship in young adults. This study examined perceptions of family alcohol use and their association with participants’ self-reported alcohol use. Participants included 171 undergraduate students (mean age = 21.67, 71.9 percent female, 75.4 percent Caucasian). Participants completed measures assessing quantity and frequency of alcohol use, negativ...

  20. Advocacy for International Family Planning: What Terminology Works?

    Science.gov (United States)

    Huber, Douglas; Martin, Raymond; Bormet, Mona

    Advocating for international family planning while avoiding miscommunications with politically and religiously conservative policy makers and the public requires care and clarity with language. We find that terms such as "international family planning" are well received when the meaning is clearly explained, such as "enabling couples to determine the number and timing of pregnancies, including the voluntary use of methods for preventing pregnancy - not including abortion - harmonious with their beliefs and values". Family planning also helps reduce abortions - a powerful message for conservative policy makers and the public. We concur with Dyer et al. (2016) that the messenger is important; we find that many of the most effective advocates are religious leaders and faith-based health providers from the Global South. They know and validate the importance of family planning for improving family health and reducing abortions in their communities. "Healthy timing and spacing of pregnancy" is positive language for policy makers, especially when describing the health impact for women and children. Universal access to contraceptive services is emerging as vital for family health and also to help achieve the Sustainable Development Goals (UN 2015). Language on international family planning will evolve, and clarity of meaning will be foundational for effective advocacy.

  1. Family accommodation in adult obsessive–compulsive disorder: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Albert U

    2017-09-01

    Full Text Available Umberto Albert, Alessandra Baffa, Giuseppe Maina Rita Levi Montalcini Department of Neuroscience, A.O.U. San Luigi Gonzaga, University of Turin, Turino, Italy Abstract: The term accommodation has been used to refer to family responses specifically related to obsessive–compulsive (OC symptoms: it encompasses behaviors such as directly participating in compulsions, assisting a relative with obsessive–compulsive disorder (OCD when he/she is performing a ritual, or helping him/her to avoid triggers that may precipitate obsessions and compulsions. At the opposite side, family responses to OCD may also include interfering with the rituals or actively opposing them; stopping accommodating OC symptoms or actively interfering with their performance is usually associated with greater distress and sometimes even with aggressive behaviors from the patients. This article summarizes progress of the recent research concerning family accommodation in relatives of patients with OCD. Family accommodation is a prevalent phenomenon both among parents of children/adolescents with OCD and relatives/caregivers of adult patients. It can be measured with a specific instrument, the Family Accommodation Scale, of which there are several versions available for use in clinical practice. The vast majority of both parents of children/adolescents with OCD and family members of adult patients show at least some accommodation; providing reassurances to obsessive doubts, participating in rituals and assisting the patient in avoidance are the most frequent accommodating behaviors displayed by family members. Modification of routine and modification of activities specifically due to OC symptoms have been found to be equally prevalent. Specific characteristics of patients (such as contamination/washing symptoms and of relatives (the presence of anxiety or depressive symptoms or a family history positive for another anxiety disorder are associated with a higher degree of family

  2. Cognitive Developmental Therapy: Aiding Adult Children of Dysfunctional Families.

    Science.gov (United States)

    Towers, David A.

    The works of Kegan and Guidano have presented cognition and emotion as complementary modes of knowing that develop together. Cognition is conceived of as being concerned with the knowledge of reality, and emotions are conceptualized as people's system for knowing of their relationship to that reality. Adult children of dysfunctional families are a…

  3. Talking (or not) about family health history in families of Latino young adults.

    Science.gov (United States)

    Corona, Rosalie; Rodríguez, Vivian; Quillin, John; Gyure, Maria; Bodurtha, Joann

    2013-10-01

    Although individuals recognize the importance of knowing their family's health history for their own health, relatively few people (e.g., less than a third in one national survey) collect this type of information. This study examines the rates of family communication about family health history of cancer, and predictors of communication in a sample of English-speaking Latino young adults. A total of 224 Latino young adults completed a survey that included measures on family communication, cultural factors, religious commitment, and cancer worry. We found that few Latino young adults reported collecting information from their families for the purposes of creating a family health history (18%) or sharing information about hereditary cancer risk with family members (16%). In contrast, slightly more than half of the participants reported generally "talking with their mothers about their family's health history of cancer." Logistic regression results indicated that cancer worry (odds ratio [OR] = 2.31; 95% confidence interval [CI] = 1.08-4.93), being female (OR = 3.12; 95% CI = 1.02-8.08), and being older (OR = 1.33; 95% CI = 1.01-1.76) were associated with increased rates of collecting information from family members. In contrast, orientation to the Latino culture (OR = 2.81; 95% CI = 1.33-5.94) and religious commitment (OR = 1.54; 95% CI = 1.02-2.32) were associated with increased rates of giving cancer information. Results highlight the need for prevention programs to help further general discussions about a family's history of cancer to more specific information related to family health history.

  4. Emerging adults' lived experience of formative family stress: the family's lasting influence.

    Science.gov (United States)

    Valdez, Carmen R; Chavez, Tom; Woulfe, Julie

    2013-08-01

    In this article, we use a phenomenology framework to explore emerging adults' formative experiences of family stress. Fourteen college students participated in a qualitative interview about their experience of family stress. We analyzed the interviews using the empirical phenomenological psychology method. Participants described a variety of family stressors, including parental conflict and divorce, physical or mental illness, and emotional or sexual abuse by a family member. Two general types of parallel processes were essential to the experience of family stress for participants. First, the family stressor was experienced in shifts and progressions reflecting the young person's attempts to manage the stressor, and second, these shifts and progressions were interdependent with deeply personal psychological meanings of self, sociality, physical and emotional expression, agency, place, space, project, and discourse. We describe each of these parallel processes and their subprocesses, and conclude with implications for mental health practice and research.

  5. International Population Assistance and Family Planning Programs: Issues for Congress

    Science.gov (United States)

    2008-07-24

    activities and USAID began to purchase contraceptives for distribution through its programs in the developing world. The first International Population...agenda of initiatives that include the promotion of gender equality, increasing adolescent education on sexuality and reproductive health, and...maintains family planning projects in more than 60 countries that include counseling and services, training of health workers, contraceptive supplies and

  6. Are Adult Children of Dysfunctional Families with Alcoholism Different from Adult Children of Dysfunctional Families without Alcoholism? A Look at Committed, Intimate Relationships.

    Science.gov (United States)

    Harrington, Christine M.; Metzler, April E.

    1997-01-01

    Compared adult children from dysfunctional families (with and without alcoholism) and adult children of functional families to gauge current relationship satisfaction. No significant differences emerged between the two dysfunctional groups. Analyses connected dysfunction in the family of origin to global distress and to difficulties with…

  7. Family Assistance for Older Adults in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Paul-Jesús Fericelli

    2013-09-01

    Full Text Available Global aging is a growing issue in most countries, including Puerto Rico. The well being of the older adult population depends mainly on a collaborative government initiative that uses both public assistance and the engagement of family members. Puerto Rican policymakers are searching for alternatives to care for the expanding elderly population as well as to protect the country’s economy, avoid the financial cliff, and reduce the high cost of public assistance. The purpose of this article is to analyze The Act for the Improvement of the Family Assistance and for the Support of the Elderly, Act No. 193 of 2002, under the criteria-based model (Gallagher & Haskins, 1984 with a value-critical appraisal (Chambers & Wedel, 2009. I suggest Act No. 193 of 2002 as a model for policymakers who are seeking ways to improve assistance for older adults, by promoting the following values: fairness, familism, fraternity, and accountability.

  8. Female children with incarcerated adult family members at risk for lifelong neurological decline.

    Science.gov (United States)

    Brewer-Smyth, Kathleen; Pohlig, Ryan T; Bucurescu, Gabriel

    2016-07-01

    A secondary analysis of data from adult female prison inmates in the mid-Atlantic United States defined relationships between having incarcerated adult family members during childhood and neurological outcomes. Of 135 inmates, 99 (60%) had one or more incarcerated adult family members during childhood. Regression analyses revealed that having incarcerated adult family members was related to greater frequency and severity of childhood abuse and higher incidence of neurological deficits in adulthood, especially related to traumatic brain injuries, compared to those without incarcerated adult family members. Along with being role models, adult family members impact the neurological health of children throughout their life-span.

  9. Female children with incarcerated adult family members at risk for life-long neurological decline

    Science.gov (United States)

    Brewer-Smyth, Kathleen; Pohlig, Ryan T.; Bucurescu, Gabriel

    2016-01-01

    A secondary analysis of data from adult female prison inmates in the mid-Atlantic United States defined relationships between having incarcerated adult family members during childhood and neurological outcomes. Of 135 inmates, 99(73%) had one or more incarcerated adult family members during childhood. Regression analyses revealed that having incarcerated adult family members was related to greater frequency and severity of childhood abuse and higher incidence of neurological deficits in adulthood, especially related to traumatic brain injuries, compared to those without incarcerated adult family members. Along with being role models, adult family members impact the neurological health of children throughout their lifespan. PMID:26788781

  10. Female children with incarcerated adult family members at risk for life-long neurological decline

    OpenAIRE

    Brewer-Smyth, Kathleen; Pohlig, Ryan T.; Bucurescu, Gabriel

    2016-01-01

    A secondary analysis of data from adult female prison inmates in the mid-Atlantic United States defined relationships between having incarcerated adult family members during childhood and neurological outcomes. Of 135 inmates, 99(73%) had one or more incarcerated adult family members during childhood. Regression analyses revealed that having incarcerated adult family members was related to greater frequency and severity of childhood abuse and higher incidence of neurological deficits in adult...

  11. International labor migration and the family: some observations from Indonesia.

    Science.gov (United States)

    Hugo, G

    1995-01-01

    This article addresses two dimensions of the complex interrelationship between the family and international labor migration in Indonesia: the role of the family in influencing labor movements out of Indonesia; and the consequences of this movement on family well-being, structure, and functioning. Research on this topic in Indonesia is highly limited due mainly to the recency of large scale international labor migration, inadequate data collection systems, a high incidence of undocumented migration, and failure of available research to be sensitive to family related issues. Against a rapidly changing economic and social situation, two major overlapping systems of migration have developed. The official system is focused strongly on the Middle East (although other Asian destinations are increasing in significance) and is dominated by female migrants. The undocumented system is much larger in volume, is focused upon Malaysia, involves more males than females, and is becoming permanent in some cases. The role, status, and experiences of women migrants in relation to their families (decision making, networks, remittances) are discussed with recommendations for other areas needing further research attention.

  12. Results from a multicentre international registry of familial Mediterranean fever

    DEFF Research Database (Denmark)

    Ozen, Seza; Demirkaya, Erkan; Amaryan, Gayane

    2014-01-01

    BACKGROUND AND AIM: Familial Mediterranean fever (FMF) is an autoinflammatory disease caused by mutations of the MEFV gene. We analyse the impact of ethnic, environmental and genetic factors on the severity of disease presentation in a large international registry. METHODS: Demographic, genetic....../year and more frequent arthritis, pericarditis, chest pain, abdominal pain and vomiting compared to the other two groups. Multivariate analysis showed that the variables independently associated with severity of disease presentation were country of residence, presence of M694V mutation and positive family...

  13. International business travel: impact on families and travellers.

    Science.gov (United States)

    Espino, C M; Sundstrom, S M; Frick, H L; Jacobs, M; Peters, M

    2002-05-01

    Spouses and staff of the World Bank Group (WBG) were questioned about the impact of international business travel on families and travellers. Dependent variables were self reported stress, concern about the health of the traveller, and negative impact on the family. We hypothesised that several travel factors (independent variables) would be associated with these impacts. These travel factors had to do with the frequency, duration, and predictability of travel and its interference with family activities. Survey forms were developed and distributed to all spouses of travelling staff as well as a small sample of operational staff. Kendall's tau b correlation coefficients of response frequencies were computed with the data from scaled items. Written responses to open ended questions were categorised. Response rates for spouses and staff were 24% and 36%, respectively. Half the spouse sample (n=533) and almost 75% of the staff sample (n=102) reported high or very high stress due to business travel. Self reported spouse stress was associated with six out of eight travel factors. Female spouses, those with children, and younger spouses reported greater stress. Self reported staff stress was significantly associated with four out of nine travel factors. Further insight into how business travel affects families and staff (including children's behavioural changes) and how families cope was gained through responses to written questions. The findings support the notion that lengthy and frequent travel and frequent changes in travel dates which affect family plans, all characteristic of WBG missions, negatively affects many spouses and children (particularly young children) and that the strain on families contributes significantly to the stress staff feel about their travel. Policies or management practices that take into consideration family activities and give staff greater leeway in controlling and refusing travel may help relieve stress.

  14. Evaluating family function in caring for a geriatric group: Family APGAR applied for older adults by home care nurses.

    Science.gov (United States)

    Wang, Mei-Wen; Huang, Yi-Yu

    2016-06-01

    Family function is an essential factor affecting older adults' health. However, there has been no appropriate method to assess the family function of most older adults with fragility or poor health status. The present study aimed to explore the differences and relevance of family function estimated by home care nurses and the older adults, and to determine if nurses could represent older adults to provide the estimation. Study participants were 50 older adults who were aged older 65 years and were taken care of at home by well-trained nurses. The present study used the Family APGAR as the questionnaire. We compared the results evaluated by the older adults and their home care nurses. The results included the level of dysfunction and the total scores of the questionnaire. The paired t-test and McNemar-Bowker test were used for the analysis. Family function could be leveled as "good," "moderate dysfunction" and "severe dysfunction" according to the scores. The family function levels estimated by nurses showed no significant differences to the patients' condition (P = 0.123 > 0.05). Comparing the total scores of the older adults with those of their own home care nurses, the results showed a moderate to nearly high correlation (R = 0.689/P older adults' family problems much earlier and to improve the their health status by enhancing family support. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

  15. Sociocultural and Familial Factors Associated with Weight Bias Internalization

    Directory of Open Access Journals (Sweden)

    Rebecca L. Pearl

    2018-04-01

    Full Text Available Background/Aims: Sociocultural and familial factors associated with weight bias internalization (WBI are currently unknown. The present study explored the relationship between interpersonal sources of weight stigma, family weight history, and WBI. Methods: Participants with obesity (N = 178, 87.6% female, 71.3% black completed questionnaires that assessed the frequency with which they experienced weight stigma from various interpersonal sources. Participants also reported the weight status of their family members and completed measures of WBI, depression, and demographics. Participant height and weight were measured to calculate body mass index (BMI. Results: Linear regression results (controlling for demographics, BMI, and depression showed that stigmatizing experiences from family and work predicted greater WBI. Experiencing weight stigma at work was associated with WBI above and beyond the effects of other sources of stigma. Participants who reported higher BMIs for their mothers had lower levels of WBI. Conclusion: Experiencing weight stigma from family and at work may heighten WBI, while having a mother with a higher BMI may be a protective factor against WBI. Prospective research is needed to understand WBI's developmental course and identify mechanisms that increase or mitigate its risk.

  16. Perceptions of Family Alcohol Use in a Young Adult Sample.

    Science.gov (United States)

    Serafini, Kelly A; Stewart, David G

    2015-09-01

    Perceptions of family alcohol use have been linked to adolescent alcohol use behaviors, yet there have been no studies that have assessed this relationship in young adults. This study examined perceptions of family alcohol use and their association with participants' self-reported alcohol use. Participants included 171 undergraduate students (mean age = 21.67, 71.9 percent female, 75.4 percent Caucasian). Participants completed measures assessing quantity and frequency of alcohol use, negative consequences of use, and sibling relationship quality. They also reported their perceptions of alcohol use for siblings and parents during a typical week. Perceptions of siblings' quantity of weekly alcohol use were significantly associated with participants' quantity of alcohol use (r = .21, p = .006) and frequency of alcohol use (r = .23, p = .002). Perceptions of parental alcohol use were not related to the participants' alcohol use patterns.

  17. Maternal differential treatment in later life families and within-family variations in adult sibling closeness.

    Science.gov (United States)

    Gilligan, Megan; Suitor, J Jill; Nam, Sangbo

    2015-01-01

    In this article, we explore within-family differences in the closeness of sibling ties in adulthood. Specifically, we consider the sibship as a network and investigate the ways in which perceptions of mothers' differential treatment play a role in within-family variations in sibling closeness in midlife. Data were analyzed from 2,067 adult sibling dyads nested within 216 later life families, collected as part of the Within-Family Differences Study-II. Respondents reported the greatest closeness to siblings whom they perceived as favored by their mothers when they were not favored themselves, whereas respondents were less likely to choose siblings whom they perceived as disfavored by their mothers when they did not perceive themselves as disfavored. Variability in the strength of sibling ties within families suggests that some individuals receive greater benefits from this relationship than do their brothers and sisters. These findings shed new light on such within-family variations in sibling closeness by identifying how specific patterns of maternal differential treatment draw offspring toward some siblings and away from others. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Impact of Childhood Family Disruption on Young Adults' Relationships with Parents.

    Science.gov (United States)

    Aquilino, William S.

    1994-01-01

    Explored implications of childhood family disruption for parent-adult child relations in sample of 4,516 young adults. Among young adults raised in single-parent families, relationships with custodial mothers and custodial fathers remained quite positive into early adulthood. Becoming noncustodial parent resulted in severe deterioration of…

  19. Expressions of Generativity through Family Leisure: Experiences of Grandparents and Adult Grandchildren

    Science.gov (United States)

    Hebblethwaite, Shannon; Norris, Joan

    2011-01-01

    The purpose of this study was to understand the expression of generativity among grandparents and their adult grandchildren through their experiences of family leisure. Fourteen dyads of grandparents and adult grandchildren were interviewed about their experience of family leisure. The findings illustrate the important role that family leisure…

  20. Domestic/family violence death reviews: an international comparison.

    Science.gov (United States)

    Bugeja, Lyndal; Dawson, Myrna; McIntyre, Sara-Jane; Walsh, Carolyn

    2015-04-01

    Domestic/Family Violence Death Reviews (D/FVDRs) have been established in a number of high-income countries since 1990 as a mechanism to inform prevention-focused interventions to reduce domestic/family violence. D/FVDRs differ in their structure, governance, case identification processes and inclusion criteria, review measures, and outputs. Outside of the United States, the extent of heterogeneity across and within countries has not been explored. This study comprised an international comparison of D/FVDRs and their core elements to inform the establishment of D/FVDRs in other developed countries, and potentially low- and middle-income countries where violence is a leading cause of death. Such a review is also a necessary foundation for any future evaluation D/FVDRs. The review identified 71 jurisdictions where a D/FVDRs had been established in the past two decades, 25 of which met the inclusion criteria. All D/FVDRs examined stated a reduction in deaths as a goal of the review process; however, none reported an actual reduction. The focus of the D/FVDRs examined was on intimate partner homicides; however, more recently established D/FVDRs include other familial relationships. Almost one third of the D/FVDRs examined reported changes to the domestic/family system that occurred as a result of recommendations made from the review process. While similar in many ways, D/FVDRs differ along a number of important dimensions that make it difficult to identify best practices for jurisdictions considering the establishment of such an initiative. To share knowledge, existing networks should be expanded nationally and internationally to include jurisdictions that may be considering this initiative. © The Author(s) 2013.

  1. INTERNAL REGULATIONS OF INTERNATIONAL COMPANIES OPERATING IN POLAND AND TRADITIONAL FAMILY MODEL

    Directory of Open Access Journals (Sweden)

    Chojara-Sobiecka Małgorzata

    2017-12-01

    Full Text Available Most of the big companies have the internal regulations about human resources management. The bylaws in question are usually created in the reality of a particular legal system. When a company expands abroad, it starts operating in a different legal system than its own. As a result, the bylaws are not always compatible neither with laws nor the legal culture of the state of a new market. The paper touches upon the problem of the cohesion of internal regulations of some of the international companies operating in Poland with the traditional family model established in Polish law analyzing three areas such as: supporting parenting, family business, and preference for non-heterosexual persons. The conclusions are that some of the internal regulations are not coherent with Polish law, and some of the bylaws regarding, e.g., daycare or flexible working hours, can be adapted to Polish legal system. It (unclear what “it” is referring to would benefit traditional model of the family. The paper contains also the excursus about some legis-lative phenomenon regarding the reception of state law regulations issues by private companies and pos-tulates that the Polish legislator shall be open to new ideas in this matter and search for the well-tried regulations.

  2. Recurrent group A streptococcal vulvovaginitis in adult women: family epidemiology.

    Science.gov (United States)

    Sobel, Jack D; Funaro, Deana; Kaplan, Edward L

    2007-03-01

    Group A beta-hemolytic streptococcal (GAS) vulvovaginitis has been reported in prepubertal girls. In adult women, a vaginal carrier state has been described, but vulvovaginitis is rarely reported. We describe 2 cases of recurrent GAS vulvovaginitis in women whose husbands were gastrointestinal carriers of GAS. Characterization of the isolated strains demonstrated that identical emm types of GAS were shared by partners. Treatment of both partners resulted in resolution of vaginitis. On the basis of negative vaginal culture results obtained after treatment of each individual episode of vaginitis, we believe that the female patients were reinfected as a result of exposure to their husbands, with shedding likely to have occurred in bed. These cases reiterate the necessity for adequate screening of the patient's family and contacts in cases of recurrent GAS infection by culturing all potential areas of GAS carriage.

  3. Measurement of the internal dose to families of outpatients treated with {sup 131}I for hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Barrington, S.F.; O' Doherty, M.J. [St. Thomas' Hospital, PET Imaging Centre, London (United Kingdom); Anderson, P. [Queen Elizabeth Hospital, Department of Nuclear Medicine, Birmingham (United Kingdom); Kettle, A.G. [Kent and Canterbury Hospital, East Kent Hospitals NHS Trust, Department of Nuclear Medicine, Canterbury (United Kingdom); Gadd, R.; Mountford, P.J. [University Hospital of North Staffordshire, Directorate of Medical Physics and Clinical Technology, Stoke-on-Trent (United Kingdom); Thomson, W.H.; Harding, L.K. [City Hospital, Department of Physics and Nuclear Medicine, Birmingham (United Kingdom); Batchelor, S. [Guy' s and St Thomas' Hospital, Department of Medical Physics, London (United Kingdom)

    2008-11-15

    The aim of this study was to measure the internal dose received by family members from ingestion of radioactive contamination after outpatient therapy. Advice was given to minimise transfer of radioiodine. Home visits were made approximately 2, 7 and 21 days after treatment to measure radioactivity in the thyroids of family members. A decay correction was applied to radioactivity detected assuming ingestion had occurred at the earlier contact time, either the day of treatment or the previous home visit. An effective half-life of 6 or 7 days was used depending on age. Thyroid activity was summed if activity was found at more than one visit in excess of the amount attributable to radioactive decay. Effective dose (ED) was calculated using ICRP72. Fifty-three adults and 92 children, median age 12 (range 4-17) years participated. Median administered activity was 576 (range 329-690) MBq {sup 131}I. Thyroid activity ranged from 0 to 5.4 kBq in the adults with activity detected in 17. Maximum adult ED was 0.4 mSv. Thyroid activity ranged from 0 to 11.8 kBq in the children with activity detected in 26. The two highest values of 5.0 and 11.8 kBq occurred in children aged 5 and 14 years from different families. Eighty-five children had no activity or <1 kBq detected. ED was <0.2 mSv in 86 out of 92 children (93%). Previous published data showed 93% of children received an ED {<=}0.8 mSv from external irradiation. With advice, families of outpatients receiving radioiodine should be able to comply with statutory dose limits and constraints. (orig.)

  4. Adult self-esteem and locus of control as a function of familial alcoholism and dysfunction.

    Science.gov (United States)

    Werner, L J; Broida, J P

    1991-05-01

    This study examines self-esteem and locus of control in adult children of alcoholics. We assessed these measures in 195 professional adults in relation to alcoholism and functioning in the family of origin. Although the presence of parental alcoholism was not a predictor of significant differences in adult self-esteem or locus of control, familial dysfunction was reflected in significant differences in self-esteem. This suggests that parental alcoholism does not necessarily result in personality differences in adult children.

  5. Parents' attachment histories and children's externalizing and internalizing behaviors: exploring family systems models of linkage.

    Science.gov (United States)

    Cowan, P A; Cowan, C P; Cohn, D A; Pearson, J L

    1996-02-01

    Twenty-seven mothers and 27 fathers were given the Adult Attachment Interview (M. Main & R. Goldwyn, in press) when their children were 3.5 years old. Continuous ratings of narrative coherence, probable experience quality (parents perceived as loving), and state of mind (current anger at parents) were entered as latent variables in partial least squares structural equation models that included observational measures of marital quality and parenting style. Models that include fathers' attachment histories predicted more variance in kindergarten teachers' descriptions of children's externalizing behavior, whereas models that include mothers' attachment histories predicted more variance in children's internalizing behavior. Marital data added predictive power to the equations. Discussion is focused on the importance of integrating attachment and family systems approaches, and of parents' gender and marital quality, in understanding specific links between parents' attachment histories and their young children's externalizing and internalizing behaviors.

  6. Triadic Interactions in Families of Adolescents with Anorexia Nervosa and Families of Adolescents with Internalizing Disorders.

    Science.gov (United States)

    Balottin, Laura; Mannarini, Stefania; Mensi, Martina M; Chiappedi, Matteo; Gatta, Michela

    2016-01-01

    The latest studies and practice guidelines for the treatment of adolescent patients with anorexia nervosa agree in pointing out the key role played by parents in determining the young patients' therapeutic possibilities and outcomes. Still family functioning has usually been studied using only self-reported instruments. The aim of the present study is therefore to investigate the triadic interactions within the families of adolescents with anorexia nervosa using a semi-standardized observational tool based on a recorded play session, the Lausanne Trilogue Play (LTP). Parents and adolescent daughters, consecutively referred to adolescent neuropsychiatric services, participated in the study and underwent the observational procedure (LTP). The 20 families of adolescent girls with anorexia nervosa (restricting type) were compared with 20 families of patients with internalizing disorders (anxiety and depression). The results showed different interactive patterns in the families of adolescents with anorexia nervosa: they had greater difficulties in respecting roles during the play, maintaining the joint attention and in sharing positive affect, especially in the three-together phase (third phase). The majority of these families (12) exhibited collusive alliances. The parental subsystem appeared frequently unable to maintain a structuring role, i.e., providing help, support and guidance to the daughters, while the girls in turn often found it hard to show independent ideas and develop personal projects. Parents experienced difficulty in carving out a couple-specific relational space, from which the ill daughter was at least temporarily excluded also when they were asked to continue to interact with each other, letting the daughter be simply present in a third-part position (fourth phase). The study of the triadic interactions in the families of adolescents with anorexia nervosa may help to shift the attention from the exclusive mother-daughter relation to the involvement

  7. The timing of family commitments in the early work career : Work-family trajectories of young adults in Flanders

    NARCIS (Netherlands)

    Koelet, S.; de Valk, H.A.G.; Glorieux, L.; Laurijssen, L.; Willaert, D.

    2015-01-01

    Objective: This article examines the diverse ways in which young adults develop both their professional career and family life in the years immediately after they complete their education. Building a career and starting a family often occur simultaneously in this stage of life. By studying the

  8. The timing of family commitments in the early work career: Work-family trajectories of young adults in Flanders

    NARCIS (Netherlands)

    Koelet, S.; de Valk, H.A.G.; Glorieux, I.; Laurijssen, I.; Willaert, D.

    2015-01-01

    OBJECTIVE This article examines the diverse ways in which young adults develop both their professional career and family life in the years immediately after they complete their education. Building a career and starting a family often occur simultaneously in this stage of life. By studying the

  9. BEYOND THE WORK-LIFE BALANCE: FAMILY AND INTERNATIONAL MOBILITY OF THE HIGHLY SKILLED

    Directory of Open Access Journals (Sweden)

    Núria Vergés Bosch

    2013-10-01

    Full Text Available International mobility of the highly skilled has become one of the cornerstones of development in the current knowledge society. Correspondingly, highly skilled personnel are impelled to move abroad in order to improve their competences and build influential professional networks. Mobility implies some advantages involving personal, social and family opportunities when movers experience handicaps in their country of origin. For movers, mobility becomes a new challenge beyond the work-family balance, particularly for women who usually take on the lion’s share of childcare and domestic tasks within the family. The literature exploring the gender dimension in relation to international mobility points to complex outcomes. Firstly, women are taking on a more active role in international mobility processes, even when they have family. Secondly, family and international mobility are interrelated both for men and for women, although family could become a hindrance, particularly for women. Thirdly, international mobility and women’s career development may interfere with family formation or modify traditional family values. Finally, families moving abroad constitute a challenge for public policy, since they present a new area of problems. We aim to analyse the relationship between international mobility and family based on in-depth interviews from a purposive sample of highly skilled personnel in science and technology. The results of our research suggest that international mobility of the highly skilled has effects on the family and vice versa; however, while international mobility and family are compatible, measures and policies to reconcile them are still insufficient.

  10. Racialization, Othering, and Coping Among Adult International Adoptees in Finland

    OpenAIRE

    Koskinen, Maarit

    2015-01-01

    This qualitative interview study examined experiences of racialization and coping among 14 adult international adoptees in Finland. The results show that adoptees encounter a range of racializations by which they are made ‘other’ and excluded from Finnishness. Racialization mostly occurs indirectly and subtly, and often by significant others, and consequently is more difficult to cope with. The findings suggest that the Finnish adoption community and adoption research should pa...

  11. Family Adult Awareness of Adolescents' Premarital Romantic and Sexual Relationships in Ghana

    Science.gov (United States)

    Bingenheimer, Jeffrey B.; Roche, Kathleen M.; Blake, Susan M.

    2017-01-01

    This study examined the circumstances under which family adults in Ghana were aware of their adolescent children's involvement in premarital relationships. It was hypothesized that factors related to the seriousness and social acceptability of the relationship would influence the likelihood of family adults' awareness in gender-specific ways. Data…

  12. Living arrangements of migrant and Dutch young adults: the family influence disentangled

    NARCIS (Netherlands)

    de Valk, H.A.G.; Billari, F.

    2007-01-01

    The purpose of this study was to examine the impact of the family of origin on whether migrant and Dutch young adults live in the parental home. Using a sample of 1,678 young adults aged between 15 and 30 years from 847 families with five different ethnic backgrounds, we identified patterns of

  13. The Likelihood of Parent-Adult Child Coresidence: Effects of Family Structure and Parental Characteristics.

    Science.gov (United States)

    Aquilino, William S.

    1990-01-01

    Estimated influence of child, parent, and family structural characteristics on likelihood of parents having coresident adult child, based on national sample of 4,893 parents. Results indicated most parents maintained own households and most parents and adult children who coresided lived in parents' home. Family structure was found to exert strong…

  14. Parental Divorce and Family Functioning: Effects on Differentiation Levels of Young Adults.

    Science.gov (United States)

    Johnson, Patrick; Throngren, Jill M.; Smith, Adina J.

    2001-01-01

    Study examines the effect of parental divorce and various dimensions of functioning in the family of origin on young adult development. Results indicate that parental divorce and family functioning significantly affect differentiation levels of young adults. Implications of the results for counselors and future researchers are provided. (Contains…

  15. Family Perspectives on Integrated Employment for Adults with Intellectual and Developmental Disabilities

    Science.gov (United States)

    Gilson, Carly B.; Carter, Erik W.; Bumble, Jennifer L.; McMillan, Elise D.

    2018-01-01

    Families are essential partners in efforts to elevate the employment outcomes of adults with intellectual and developmental disabilities (IDD). We examined the employment-related expectations, preferences, and concerns of 673 parents and other family members of adults with IDD. Participants prioritized paid integrated employment over sheltered…

  16. Childhood family disruptions and adult well-being: the differential effects of divorce and parental death.

    Science.gov (United States)

    Mack, K Y

    2001-01-01

    This study draws on attachment theory and social learning theory and uses data from the National Survey of Families and Households to examine the differential effects of childhood family disruptions on adult well-being. Comparisons are made between adults who experienced parental divorce, adults who experienced parental death, and adults who were raised in intact families (N = 4,341). The present study differs from previous research by making direct comparisons between different family disruption groups, assessing the effects of family disruptions that occur before age 19, and including multiple measures of adult well-being as dependent variables. Consistent with hypotheses and inferences made from comparisons with adults from intact families, adults who experienced parental divorce report lower levels of parent-child relationship quality, higher levels of self-confidence, and lower levels of depression than adults who experienced parental death during childhood. Therefore, studies that fail to take type of childhood family disruption into account will lead to inaccurate and misleading conclusions about the effects of these experiences on adult outcomes.

  17. Family dinner frequency, settings and sources, and body weight in US adults.

    Science.gov (United States)

    Sobal, Jeffery; Hanson, Karla

    2014-07-01

    Contemporary families and food systems are both becoming more dynamic and complex, and current associations between adult family meals and body mass index (BMI) are not well understood. This investigation took a new approach by examining diverse settings and sources of food for family dinners in relationship to BMI in a cross-sectional nationally representative survey of 360 US adults age 18-85 living with family members. In this sample, 89% of adults ate family dinners at least 5 days per week and almost all ate family dinners cooked and eaten at home. About half of these adults also ate family dinners at restaurants, fast food places, or ate takeout food at home, and less common were family dinners at homes of relatives or friends. Family dinners eaten at fast food places, but not other settings or sources, were significantly associated with higher BMI. Overall, adult family dinners were commonplace, usually involved home cooking, and when at fast food places may be related with higher adult body weights. Copyright © 2014. Published by Elsevier Ltd.

  18. Validity of the International Fitness Scale "IFIS" in older adults.

    Science.gov (United States)

    Merellano-Navarro, Eugenio; Collado-Mateo, Daniel; García-Rubio, Javier; Gusi, Narcís; Olivares, Pedro R

    2017-09-01

    To validate the "International Fitness Scale" (IFIS) in older adults. Firstly, cognitive interviews were performed to ensure that the questionnaire was comprehensive for older Chilean adults. After that, a transversal study of 401 institutionalized and non-institutionalized older adults from Maule region in Chile was conducted. A battery of validated fitness tests for this population was used in order to compare the responses obtained in the IFIS with the objectively measured fitness performance (back scratch, chair sit-and-reach, handgrip, 30-s chair stand, timed up-and-go and 6-min walking). Indicated that IFIS presented a high compliance in the comprehension of the items which defined it, and it was able of categorizing older adults according to their measured physical fitness levels. The analysis of covariance ANCOVA adjusted by sex and age showed a concordance between IFIS and the score in physical fitness tests. Based on the results of this study, IFIS questionnaire is a good alternative to assess physical fitness in older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Impact of family history on relations between insulin resistance, LDL cholesterol and carotid IMT in healthy adults.

    LENUS (Irish Health Repository)

    Anderwald, Christian

    2010-08-01

    Insulin resistance (IR) is implicated as an independent risk factor for vascular disease. The aim of this study was to assess the impact of family history (FH) of type 2 diabetes (T2DM) and\\/or cardiovascular disease (CVD) on the associations between IR, low-density-lipoprotein cholesterol (LDL-C) and subclinical atherosclerosis (common and internal carotid artery intima media thickness (IMT)) in healthy European adults.

  20. Adult Outcome of Children Reared for Long-Term Periods in Foster Families.

    Science.gov (United States)

    Dumaret, Annick-Camille; Coppel-Batsch, Marthe; Couraud, Simone

    1997-01-01

    Assessment of adult outcomes of 59 children from severely psychosocially dysfunctional families, who were placed in foster families for at least five years, found most had overcome their childhood adversities with 56% well-integrated socially and only 10% in situations of failure. Difficulties were linked to multiple family disturbances, traumatic…

  1. Family Health History Communication Networks of Older Adults: Importance of Social Relationships and Disease Perceptions

    Science.gov (United States)

    Ashida, Sato; Kaphingst, Kimberly A.; Goodman, Melody; Schafer, Ellen J.

    2013-01-01

    Older individuals play a critical role in disseminating family health history (FHH) information that can facilitate disease prevention among younger family members. This study evaluated the characteristics of older adults and their familial networks associated with two types of communication ("have shared" and "intend to share…

  2. Interdependent recovery of adults with schizophrenia: Asian American consumer perspectives of family involvement and influence.

    Science.gov (United States)

    Lee, Karen Kyeunghae; Yamada, Ann-Marie; Kim, Min Ah; Dinh, Tam Q

    2015-09-01

    Family involvement is important in the recovery experience of culturally diverse adults with schizophrenia. However, little is known about the influence of family among consumers purported to have close family ties without regular contact. This study explored Asian American consumers' views about family relationships and participation in their recovery. Secondary analysis of qualitative data from a larger project was conducted to explore family related themes of 8 Asian Americans receiving services from recovery-focused programs in urban Southern California. Most consumers described their family support as adequate while simultaneously reporting limited family involvement. Asia-born and U.S.-born Asian consumers varied in describing family support, suggesting providers consider nativity in culturally responsive service delivery. Families need not be present to affect the perspectives of Asian Americans receiving recovery-oriented services. The extent of family influences on recovery, beyond the initial determination of current family contact, requires further exploration. (c) 2015 APA, all rights reserved).

  3. How Older Adults and Their Families Perceive Family Talk about Aging-Related EOL Issues: A Dialectical Analysis.

    Science.gov (United States)

    Egbert, Nichole; Child, Jeffrey T; Lin, Mei-Chen; Savery, Carol; Bosley, Tammy

    2017-04-17

    For older adults, approaching end-of-life (EOL) brings unique transitions related to family relationships. Unfortunately, most families greatly underestimate the need to discuss these difficult issues. For example, parents approaching EOL issues often struggle with receiving assistance from others, avoiding family conflict, and maintaining their sense of personhood. In addition, discussions of EOL issues force family members to face their parents' mortality, which can be particularly difficult for adult children to process emotionally. This study explored aging issues identified by aging parents and their families as they traverse these impending EOL changes. Ten focus groups of seniors ( n = 65) were conducted. Focus groups were organized according to race (African-American/European-American), gender, and whether the older adult was living independently or in an assisted care facility. When asked open-ended questions about discussing aging and EOL issues with family members, participants revealed tensions that led us to consider Relational Dialectics Theory as a framework for analysis. The predominant tension highlighted in this report was certainty versus uncertainty, with the two sub-themes of sustained life versus sustained personhood and confronting versus avoiding EOL issues. For these data, there were more similarities than differences as a result of gender, race, or living situation than one might expect, although culture and financial status were found to be influential in the avoidance of EOL discussions. The results of this study help to provide additional insight into relational dialectics related to aging, EOL, and the importance of communication in facilitating family coping.

  4. Profession differences in family focused practice in the adult mental health system.

    Science.gov (United States)

    Maybery, Darryl; Goodyear, Melinda; O'Hanlon, Brendan; Cuff, Rose; Reupert, Andrea

    2014-12-01

    There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross-sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices. © 2014 Family Process Institute.

  5. "That was grown folks' business": narrative reflection and response in older adults' family health history communication.

    Science.gov (United States)

    Yamasaki, Jill; Hovick, Shelly R

    2015-01-01

    Given the importance of family health history and the pivotal role of older adults in communicating it, this study examines how African American older adults (a) characterize their understandings of health-related conditions in their family histories and (b) rationalize their motivations and constraints for sharing this information with current family members. Using narrative theory as a framework, we illustrate how the participants reflect on prior health-related experiences within the family to respond to moral and practical calls for communicating family health information to current relatives. Specifically, our analysis highlights how storied family secrets--as constructed by 28 participants in group and individual interviews--reveal and inform shifting cultural and generational practices that shape the lived health behaviors and communication of older adults at greater risk for health disparities.

  6. Factors influencing life satisfaction of Korean older adults living with family.

    Science.gov (United States)

    Sok, Sohyune R

    2010-03-01

    The purpose of this study was to identify the factors influencing life satisfaction of Korean older adults living with family. Participants included 267 adults age 65 and older who met eligibility criteria. Analyses showed that the prediction model of the life satisfaction of older adults who are living with their family was significant (F=24.429, ppocket money (beta=0.060), and age (beta=0.040). It is possible that older adults' life satisfaction increases when they are provided with nursing interventions and are able to effectively manage their health. Nursing interventions must strive to improve their self-esteem and address their depression.

  7. Children's Drawings: Self-Perception and Family Function in International Adoption

    Science.gov (United States)

    Bannon, Brittany L.; Tirella, Linda G.; Miller, Laurie C.

    2016-01-01

    No comprehensive studies have examined the utility of family drawings within the context of international adoption. We examined the relationship of Kinetic Family Drawings by 54 internationally adopted children in the USA (65% female; M age = 8.57 years, SD = 2.1) to demographics, child competencies (Child Behavior Checklist: CBCL/6-18) and…

  8. Intra-family stressors among adult siblings sharing caregiving for parents.

    Science.gov (United States)

    Ngangana, Pamela C; Davis, Bertha L; Burns, Dorothy P; McGee, Zina T; Montgomery, Arlene J

    2016-12-01

    The aim of this study was to describe a Neuman Systems Model-guided study of perceptions of family stressors experienced by adult siblings who share caregiving for their parents and the influence of these stressors on adult siblings' relationships. The task of providing informal care for disabled parents is often shared by adult siblings. Family stressors experienced as part of caregiving may affect the sibling relationship. A mixed-method study design was used. Data were collected during 2013-2014 from 84 adult sibling caregivers. Seventy-two caregivers provided quantitative data for the Lifespan Sibling Relationship Scale and the Zarit Burden Scale and 79 provided qualitative data for the open-ended question. Adult siblings experienced mild-to-moderate levels of burden from family stressors when they share parental caregiving. The amount of burden from intra-family stressors was negatively related to the adult sibling relationship. Beneficial and noxious stressors were evident in the participants' responses to an open-ended question. The health of the parents affected the lives of adult siblings in both negative and positive ways. Although the majority of the adult siblings expressed a willingness to care for their parent(s) in an attempt to reciprocate the care, they had received from them, challenges emerged from dealing with family stressors. © 2016 John Wiley & Sons Ltd.

  9. Death with dignity from the perspective of the surviving family: a survey study among family caregivers of deceased older adults.

    Science.gov (United States)

    van Gennip, Isis E; Pasman, H Roeline W; Kaspers, Pam J; Oosterveld-Vlug, Mariska G; Willems, Dick L; Deeg, Dorly J H; Onwuteaka-Philipsen, Bregje D

    2013-07-01

    Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. (1) To assess the prevalence of death with dignity in older adults from the perspective of family caregivers, (2) to determine factors that diminish dignity during the dying phase according to family caregivers, and (3) to identify physical, psychosocial, and care factors associated with death with dignity. A survey study with a self-administered questionnaire. Family caregivers of 163 deceased older (>55 years of age) adults ("patients") who had participated in the Longitudinal Aging Study Amsterdam. Of the family caregivers, 69% reported that their relative had died with dignity. Factors associated with a dignified death in a multivariate regression model were patients feeling peaceful and ready to die, absence of anxiety and depressive mood, presence of fatigue, and a clear explanation by the physician of treatment options during the final months of life. The physical and psychosocial condition of the patient in combination with care factors contributed to death with dignity from the perspective of the family caregiver. The patient's state of mind during the last phase of life and clear communication on the part of the physician both seem to be of particular importance.

  10. The Corporate Social Responsibility of Family Businesses: An International Approach

    Directory of Open Access Journals (Sweden)

    Gérard Hirigoyen

    2014-07-01

    Full Text Available This study analyzes the links between listed family businesses and social responsibility. On the theoretical level, it establishes a relationship between socioemotional wealth, proactive stakeholder engagement, and the social responsibility of family businesses. On a practical level, our results (obtained from a sample of 363 companies show that family businesses do not differ from non-family businesses in many dimensions of social responsibility. Moreover, family businesses have statistically significant lower ratings for four sub-dimensions of “corporate governance”, namely “balance of power and effectiveness of the Board”, “audit and control mechanisms”, “engagement with shareholders and shareholder structure”, and “executive compensation”.

  11. Family Communication, Risk Perception and Cancer Knowledge of Young Adults from BRCA1/2 Families: a Systematic Review.

    Science.gov (United States)

    Young, Alison L; Butow, Phyllis N; Vetsch, Janine; Quinn, Veronica F; Patenaude, Andrea F; Tucker, Katherine M; Wakefield, Claire E

    2017-12-01

    Understanding challenges in familial communication of cancer risk has informed genetic service delivery. Parent-child interactions have received considerable attention, but few studies focus on young adulthood experiences within BRCA1/2 families. Young adults are approaching, or at a life stage where awareness of hereditary cancer risk is vital for informed choice of risk management options. This review assesses family communication, risk perception and cancer knowledge held by 18-40 year old individuals who have a parent with a BRCA1/2 gene mutation or carry the gene mutation themselves. Thirteen papers met the inclusion criteria. One utilized a 'mixed methods' methodology and the remaining used a qualitative approach. Findings were synthesized into themes and reported narratively. In general, parents are communicating openly about genetic risk with young adult offspring, but there is evidence that some young adults are withholding information from their parents about their own test results. Risk perception is influenced by a family history of cancer, childbearing plans and health providers' advice. Misconceptions about genetic risk appear to be common and gaps in hereditary cancer knowledge are evident. It is unclear whether incorrect knowledge was passed from parents to offspring. Health providers need to provide developmentally appropriate services for emerging adults (18-25 years old), with particular support in navigating through risk management options.

  12. Family support and blood pressure pattern in adult patients ...

    African Journals Online (AJOL)

    The prevalence of hypertension is increasing worldwide but awareness, treatment and control rates are very poor. Hence, this study ... Data was analyzed using Stata statistical software (Version 10). Results: The mean age ... in clinical practice. Keywords: Hypertension, Family Support, Awareness, Control, Family Physician ...

  13. Management of Change in Tourism - The Problem of Family Internal Succession in Family Tourism SMEs

    OpenAIRE

    Zehrer, Anita; Haslwanter, Julia

    2010-01-01

    “World-wide, the family business constitutes the most prevalent form of business or-ganization” (Poutziouris et al. 2004, p. 7). Alpine tourism is also dominated by small- and medium-sized enterprises (SME), among which family firms represent the majority (Astrachan and Shanker 2003). Family firms are urged to perform business, strategic, and succession planning for their survival (Knight 1993). Planning for the integration of the younger generation into the family firm is an issue of strateg...

  14. Illinois State Plan: Adult Education and Family Literacy. Under Title II of the Workforce Investment Act of 1998, Adult Education and Family Literacy Act

    Science.gov (United States)

    Illinois Community College Board, 2014

    2014-01-01

    This document contains Illinois' State Plan for Adult Education and Family Literacy under Title II of the Workforce Investment Act of 1998 for July 1, 1999, through June 30, 2015. The plan is comprised of the following sections: (1) Eligible agency certifications and assurances; (2) Description of the steps to ensure direct and equitable access;…

  15. Family cultural socialization practices and ethnic identity in college-going emerging adults.

    Science.gov (United States)

    Juang, Linda; Syed, Moin

    2010-06-01

    We examined how family cultural socialization related to the ethnic identity of Asian American, Latino, White, and Mixed-Ethnic emerging adults (N=225). Greater family cultural socialization was related to greater ethnic identity exploration and commitment. Ethnic minority students reported higher levels of family cultural socialization and ethnic identity compared to White students. The family cultural socialization-ethnic identity link was more pronounced for females compared to males, and for White compared to ethnic minority students. The findings highlight the importance of the family for identity development beyond adolescence.

  16. Aging Parents with Adult Mentally Retarded Children: Family Risk Factors and Sources of Support.

    Science.gov (United States)

    Seltzer, Marsha Mailick; Krauss, Marty Wyngaarden

    1989-01-01

    Predictors of 4 indices of well-being (physical health, life satisfaction, burden, and parenting stress) were examined among 203 aging mothers of mentally retarded adults living at home. Predictive variables examined include maternal characteristics, retarded adult's characteristics, family social climate, mother's social support network, and…

  17. Tracking an Elusive Population: Family Carers of Older Adults with Intellectual Disabilities in Romandy (Switzerland)

    Science.gov (United States)

    Jecker-Parvex, Maurice; Breitenbach, Nancy

    2012-01-01

    Despite a long-standing tradition of institutional placement in Switzerland, many older adults with intellectual disabilities continue to be supported by aging parents and siblings. For various reasons, these carers and the adults concerned have been overlooked up to now. To find out how many such families are providing housing and care of this…

  18. Older and Younger Family Caregivers of Adults with Intellectual Disability: Factors Associated with Future Plans

    Science.gov (United States)

    Chou, Yueh-Ching; Lee, Yue-Chune; Lin, Li-Chan; Kroger, Teppo; Chang, Ai-Ning

    2009-01-01

    A structured interview survey was conducted in a major city in Taiwan to explore and compare older and younger family primary caregivers' well being and their future caregiving plans for these adults with intellectual disability. The sample size was 315 caregivers who were 55 years or older and who cared for adults with intellectual disability and…

  19. Becoming Stronger at Broken Places: A Model for Group Work with Young Adult from Divorced Families.

    Science.gov (United States)

    Hage, Sally M.; Nosanow, Mia

    2000-01-01

    Describes a model for group work with young adults from divorced families using an 8-session psychoeducational group intervention. Goals include reducing isolation, establishing connectedness, and building a stronger sense of identify. By educating young adults on topics such as assertiveness, communication skills, and self-esteem, it will give…

  20. Prime-Time Television Portrayals of Older Adults in the Context of Family Life.

    Science.gov (United States)

    Dail, Paula W.

    1988-01-01

    Content analyzed portrayal of older adults in 12 family-oriented, prime-time television programs to determine cognitive, physical, and health status; social interaction; and emotional behavior. Among 193 characters portraying elderly adults, 3,468 verbalizations and behaviors were examined. Results suggest that persons over age 55 are more…

  1. Systemic Family Therapy Using the Reflecting Team: The Experiences of Adults with Learning Disabilities

    Science.gov (United States)

    Anslow, Katharine

    2014-01-01

    This research aimed to illuminate the experiences of adults with learning disabilities of the reflecting team, in the context of their systemic family therapy. Five adults with learning disabilities were recruited from one community learning disability team. A qualitative design using interpretative phenomenological analysis (IPA) was appropriate…

  2. Family Environment and Behavior Problems in Children, Adolescents, and Adults with Fragile X Syndrome

    Science.gov (United States)

    Greenberg, Jan S.; Seltzer, Marsha Mailick; Baker, Jason K.; Smith, Leann E.; Warren, Steven F.; Brady, Nancy; Hong, Jinkuk

    2012-01-01

    We examine how the family environment is associated with aspects of the Fragile X syndrome phenotype during childhood, adolescence, and adulthood. Mothers of children (n = 48), adolescents (n = 85), and adults (n = 34) with Fragile X syndrome participated in a multisite study. For children and adults with Fragile X syndrome, the presence of warmth…

  3. Long term effects of parenting and family characteristics on delinquency of male young adults

    NARCIS (Netherlands)

    Hoeve, M.; Smeenk, W.; Loeber, R.; Southamer-Loeber, M.; van der Laan, P.H.; Gerris, J.R.; Dubas, J.S.

    2007-01-01

    Drawing from the criminology literature and family studies, we investigated the long-term effects of established family risk factors and parenting styles on male young adult delinquency. We used data sets from two longitudinal studies, the Pittsburgh Youth Study (N474) and the Child-Rearing and

  4. Characteristics of People Providing Family Placements to Adult Persons with Intellectual Disabilities

    Science.gov (United States)

    McConkey, Roy; McConaghie, Jayne; Roberts, Paul; King, Diana

    2005-01-01

    The success of family placement schemes depends largely on the recruitment of suitable people who are willing to offer placements in their own home yet little research has been undertaken of their characteristics and the reasons for their involvement. Thirty providers of family based placements to adult persons with intellectual disabilities were…

  5. Family Caregiver Uplift and Burden: Associations with Aggressive Behavior in Adults with Intellectual Disability

    Science.gov (United States)

    Unwin, Gemma; Deb, Shoumitro

    2011-01-01

    The purpose of this study was to investigate the experience of family caregivers caring for adults with intellectual disabilities (ID) who display aggressive behavior in terms of associations with caregiver burden and uplift. The family caregivers of 44 people with ID and aggressive behavior were interviewed using a suite of questionnaires and…

  6. The Family's Influence on Adolescent and Young Adult Career Development: Theory, Research and Practice.

    Science.gov (United States)

    Hughes, Cathy; Thomas, Trang

    2003-01-01

    A research review identified a range of family process variables associated with enhanced career development for adolescents and young adults. Findings were consistent with the theories of Roe (personality development and career choice) and Super (life-span, life-space) regarding the influence of family processes on career development. (Contains…

  7. Comparison of family-planning service quality reported by adolescents and young adult women in Mexico.

    Science.gov (United States)

    Darney, Blair G; Saavedra-Avendano, Biani; Sosa-Rubi, Sandra G; Lozano, Rafael; Rodriguez, Maria I

    2016-07-01

    Associations between age and patient-reported quality of family planning services were examined among young women in Mexico. A repeated cross-sectional analysis of survey data collected in 2006, 2009, and 2014 was performed. Data from women aged 15-29years who had not undergone sterilization and were currently using a modern contraceptive method were included. The primary outcome was high-quality care, defined as positive responses to all five quality items regarding contraceptive services included in the survey. Multivariable logistic regression and marginal probabilities were used to compare adolescents and women aged 20-29years. The responses of respondents using different contraceptive methods were compared. Data were included from 15 835 individuals. The multivariable analysis demonstrated lower odds of reporting high-quality care among women aged 15-19years (odds ratio 0.73; 95% confidence interval 0.60-0.88) and 20-24years (odds ratio 0.85; 95% confidence interval 0.75-0.96) compared with women aged 25-29years. Adolescents using hormonal and long-acting reversible contraception had significantly lower odds of reporting high-quality care compared with women aged 25-29. Adolescents in Mexico reported a lower quality of family planning services compared with young adult women. Continued research and policies are needed to improve the quality of contraceptive services. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  8. International Population Assistance and Family Planning Programs: Issues for Congress

    National Research Council Canada - National Science Library

    Blanchfield, Luisa

    2008-01-01

    ...." The Mexico City policy denies U.S. funds to foreign nongovernmental organizations (NGOs) that perform or promote abortion as a method of family planning -- even if the activities are undertaken with non-U.S. funds...

  9. Poverty and Family Structure - Phase II | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Understanding the dynamics of change in family structure is critical in poverty diagnosis, ... And, how could public social security be conceived to protect the most vulnerable? ... IDRC invites applications for the IDRC Research Awards 2019.

  10. Sri Lanka Telecentre Family Network Project | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sri Lanka Telecentre Family Network Project ... will require telecentre manager training, technical and business support, and knowledge-sharing across programs. ... IWRA/IDRC webinar on climate change and adaptive water management.

  11. Preparing Family Caregivers to Recognize Delirium Symptoms in Older Adults After Elective Hip or Knee Arthroplasty.

    Science.gov (United States)

    Bull, Margaret J; Boaz, Lesley; Maadooliat, Mehdi; Hagle, Mary E; Gettrust, Lynn; Greene, Maureen T; Holmes, Sue Baird; Saczynski, Jane S

    2017-01-01

    To test the feasibility of a telephone-based intervention that prepares family caregivers to recognize delirium symptoms and how to communicate their observations to healthcare providers. Mixed-method, pre-post quasi-experimental design. A Midwest Veterans Affairs Medical Center and a nonprofit health system. Forty-one family caregiver-older adult dyads provided consent; 34 completed the intervention. Four telephone-based education modules using vignettes were completed during the 3 weeks before the older adult's hospital admission for elective hip or knee replacement. Each module required 20 to 30 minutes. Interviews were conducted before the intervention and 2 weeks and 2 months after the older adult's hospitalization. A researcher completed the Confusion Assessment Method (CAM) and a family caregiver completed the Family Version of the Confusion Assessment Method (FAM-CAM) 2 days after surgery to assess the older adults for delirium symptoms. Family caregivers' knowledge of delirium symptoms improved significantly from before the intervention to 2 weeks after the intervention and was maintained after the older adult's hospitalization. They also were able to recognize the presence and absence of delirium symptoms in the vignettes included in the intervention and in the older adult after surgery. In 94% of the cases, the family caregiver rating on the FAM-CAM approximately 2 days after the older adult's surgery agreed with the researcher rating on the CAM. Family caregivers expressed satisfaction with the intervention and stated that the information was helpful. Delivery of a telephone-based intervention appears feasible. All family caregivers who began the program completed the four education modules. Future studies evaluating the effectiveness of the educational program should include a control group. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  12. Talking (or Not) about Family Health History in Families of Latino Young Adults

    Science.gov (United States)

    Corona, Rosalie; Rodríguez, Vivian; Quillin, John; Gyure, Maria; Bodurtha, Joann

    2013-01-01

    Although individuals recognize the importance of knowing their family's health history for their own health, relatively few people (e.g., less than a third in one national survey) collect this type of information. This study examines the rates of family communication about family health history of cancer, and predictors of communication in a…

  13. Strategies for sustaining self used by family caregivers for older adults with dementia.

    Science.gov (United States)

    Bull, Margaret J

    2014-06-01

    The negative health consequences of caring for an older adult family member with dementia are well documented. However, not all family caregivers experience these negative health consequences. The purposes of this study were to describe strategies family caregivers use to help them continue to provide care for an older family member with dementia despite challenges and describe these family caregivers' resilience and psychological distress. A mixed methods design was used with a narrative approach dominant and standardized scales for resilience and psychological distress used to enhance the description of the sample. Data were collected through telephone interviews with 18 family caregivers residing in an urban area. The findings indicate that family caregivers used four strategies to sustain the self: drawing on past life experiences, nourishing the self, relying on spirituality, and seeking information about dementia. Understanding strategies used by family caregivers to sustain themselves is essential for providing holistic nursing care and developing effective interventions.

  14. Family Structure and Adolescent Substance Use: An International Perspective.

    Science.gov (United States)

    Hoffmann, John P

    2017-11-10

    Numerous studies indicate that family structure is a key correlate of adolescent substance use. Yet there are some important limitations to this research. Studies have been conducted mainly in the United States, with relatively few studies that have compared family structure and youth substance use across nations. There is also a lack of recognition of the complexity of family types prevalent in contemporary global society. Moreover, there remains a need to consider personal, interpersonal, and macro-level characteristics that may help account for the association between family structure and youth substance use. This study uses data from 37 countries to examine several models that purport to explain the association between family structure and substance use. The data are from the 2005-2006 WHO-sponsored Health Behaviour in School-Aged Children (HBSC) (n = 193,202). Multilevel models, including linear, probit, and structural equation models (SEMs), were used to test several hypotheses. The results suggest that time spent with friends largely accounted for the association between specific types of family structures and frequency of alcohol use and getting drunk, but that cannabis use was negatively associated with living with both biological parents irrespective of other factors.

  15. Unrecognized pediatric and adult family members of children with acute brucellosis.

    Science.gov (United States)

    Çiftdoğan, Dilek Yılmaz; Aslan, Selda

    Brucellosis is an infectious, contagious and zoonotic disease that occurs worldwide. The family members of an index case of brucellosis may be especially susceptible, due to sharing the same source of infection and similar risk factors for brucellosis. In this study, we propose to screen pediatric and adult family members of brucellosis index cases for detecting additional unrecognized infected family members. 114 family members of 41 pediatric patients with brucellosis were evaluated. All family members completed a brief questionnaire and were tested by a standard tube agglutination test (STA). The majority of family members (n=96, 84.2%) were children. Among the 114 family members, 42 (36.8%) were seropositive, and 15 (35.7%) were symptomatic. The majority of the symptomatic seropositive family members (n=12, 80%) had STA titers (≥1:640) higher than asymptomatic seropositive family members (n=9, 33%; p=0.004). The routine screening of both pediatric and adult family members of index cases is a priority in endemic areas. Using this screening approach, unrecognized family members who are seropositive for brucellosis will be identified earlier and be able to receive prompt treatment. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  16. Conditional Mediation of Absorptive Capacity and Environment in International Entrepreneurial Orientation of Family Businesses.

    Science.gov (United States)

    Hernández-Perlines, Felipe; Xu, Wenkai

    2018-01-01

    This study analyzes the effect of conditional mediation of environment-absorptive capacity in international entrepreneurial orientation of family businesses. Results involve data from 218 Spanish family businesses, analyzed with SmartPLS 3.2.7 software. This paper presents a relevant contribution both to the academic field and the performance of family firms, helping to understand the process of transforming international entrepreneurial orientation into a better international performance through absorptive capacity while family businesses invest their efforts in aligning international entrepreneurial orientation and absorptive capacity with international results, bearing in mind the positive moderator effect of environment. The most relevant contribution of this work is to integrate in the same model the mediating effect of the absorption capacity and the moderating effect of the environment: the effect of the international entrepreneurial orientation on the international performance of family businesses improves with the mediation of the absorptive capacity (the variability of international performance goes from 32.5 to 40.6%) and the moderation of the environment (to variability of international performance goes from 40.6 to 45.3%).

  17. Parental divorce during early adolescence in Caucasian families: the role of family process variables in predicting the long-term consequences for early adult psychosocial adjustment.

    Science.gov (United States)

    Summers, P; Forehand, R; Armistead, L; Tannenbaum, L

    1998-04-01

    The relationship between parental divorce occurring during adolescence and young adult psychosocial adjustment was examined, as was the role of family process variables in clarifying this relationship. Participants were young Caucasian adults from divorced (n = 119) and married (n = 123) families. Assessments were conducted during adolescence and 6 years later during early adulthood. Young adults from married families reported more secure romantic attachments than those from divorced families; however, differences were not evident in other domains of psychosocial adjustment after demographic variables were controlled. Three family process variables (parent-adolescent relationship, interparental conflict, and maternal depressive symptoms) were examined as potential mediators and moderators of the association between parental divorce and young adult adjustment. No evidence supporting mediation or moderation was found; however, the parent-adolescent and parent-young adult relationships, particularly when the identified parent was the father, emerged as significant predictors of young adult psychosocial adjustment.

  18. Cognitive-electrophysiological indices of attentional and inhibitory processing in adults with ADHD: familial effects

    Directory of Open Access Journals (Sweden)

    McLoughlin Gráinne

    2011-07-01

    Full Text Available Abstract Background Attention deficit hyperactivity disorder (ADHD is a common neurodevelopmental disorder that starts in childhood and frequently persists in adults. In a comparison of adults with ADHD and a matched control sample, we previously showed that abnormal inhibitory processing is typically preceded or accompanied by other processing deficits in adult ADHD. We now compare these data further to additional data from first-degree relatives (fathers of children with ADHD to identify whether this pattern of abnormal processing shares familial influences with ADHD in adults. Methods Using a family design, we compared 20 fathers of children with the combined subtype of ADHD with 21 adults with ADHD combined subtype and 20 controls in event-related potential indices of preparatory states and subsequent response inhibition processing as elicited by a cued continuous performance task. Results Fathers of children with ADHD exhibited significantly weaker orienting attention to cues and inhibitory processing than the controls but not the ADHD sample. Conclusions These findings provide evidence for the familial association of attentional orienting and response inhibition processes with ADHD in adults and indicate a familial and neurobiological link between ADHD in children and adults.

  19. The timing of family commitments in the early work career: Work-family trajectories of young adults in Flanders

    Directory of Open Access Journals (Sweden)

    Suzana Koelet

    2015-03-01

    Full Text Available Objective: This article examines the diverse ways in which young adults develop both their professional career and family life in the years immediately after they complete their education. Building a career and starting a family often occur simultaneously in this stage of life. By studying the simultaneous developments in these life domains, we can gain a better understanding of this complex interplay. Methods: The data consist of a sample of 1,657 young adults born in 1976 who were interviewed as part of the SONAR survey of Flanders at ages 23, 26, and 29 about their education, their entry into and early years on the labour market, and their family life. Sequence analysis is used to study the timing of union formation and having children among these young adults, as well as how these events are related to their work career. Multinomial regression analysis is applied to help us gain a better understanding of the extent to which these life course patterns are determined by education and economic status at the start of the career. Results: The results reveal a set of work-family trajectories which vary in terms of the extent of labour market participation and the type and timing of family formation. Various aspects of the trajectory are found to be determined by different dimensions of an individual's educational career (duration, level, field of study. Education is more relevant for women than for men, as a man's trajectory is more likely than a woman's to be determined by the first job. Conclusions: By using a simultaneous approach which takes into account both family and work, this life course analysis confirms that men have a head start on the labour market, and examines the factors which influence the distinct trajectories of young women and men.

  20. Family PArtners in Lifestyle Support (PALS): Family-Based Weight Loss for African American Adults with Type 2 Diabetes

    Science.gov (United States)

    Samuel-Hodge, Carmen D.; Holder-Cooper, Judith C.; Gizlice, Ziya; Davis, Gwendolyn; Steele, Sonia P.; Keyserling, Thomas C.; Kumanyika, Shiriki K.; Brantley, Phillip J.; Svetkey, Laura P.

    2016-01-01

    Objective To develop and test a family-centered behavioral weight loss intervention for African American adults with type 2 diabetes. Methods In this randomized trial, dyads consisting of African American adult with overweight or obesity and type 2 diabetes (index participant) paired with a family partner with overweight or obesity, but not diagnosed with diabetes, were assigned in a 2:1 ratio to a 20-week special intervention (SI) or delayed intervention (DI) control group. The primary outcome was weight loss among index participants at 20 weeks follow-up. Results One hundred-eight participants (54 dyads – 36 (SI) and 18 (DI) dyads) were enrolled: 81% females; mean age, 51 years; mean weight,103 kg; and mean BMI, 37 kg/m2. At post-intervention, 96 participants (89%) returned for follow-up measures. Among index participants, mean difference in weight loss between groups was −5.0 kg, pfamily interactions, and dietary, physical activity, and diabetes self-care behaviors. SI family partners also had significant weight loss (−3.9 kg (SI) vs. −1.0 kg (DI) p=0.02). Conclusions A family-centered, behavioral weight loss intervention led to clinically significant short-term weight loss among family dyads. PMID:27911049

  1. Self-transcendence and family caregivers of adults with dementia.

    Science.gov (United States)

    Acton, G J; Wright, K B

    2000-06-01

    Research has documented that caring for a family member with dementia is stressful and burdensome. However, difficult life experiences such as fear, loss, and grief may help persons move beyond a concern for self toward a larger perspective and concern for others. Both positive and negative experiences can promote positive movement toward growth and development. This movement has been described as self-transcendence, or the ability to look beyond the self and present difficulties, to extend concern to others, and to find personal meaning and wholeness in the context of life-changing events. The family caregiving experience with its inherent difficulties might provide the impetus for such a movement toward self-transcendence. The purpose of this article is to examine the concept of self-transcendence, explore its linkages to the caregiving experience, and suggest potential strategies to assist family caregivers to achieve self-transcendence.

  2. Adult family relationships in the context of friendship

    Science.gov (United States)

    Fuller-Iglesias, Heather R.; Webster, Noah; Antonucci, Toni C.

    2013-01-01

    The present study examined the complex way in which relationships with family and friends shape health and well-being in adulthood over time. Specifically, we explored whether the longitudinal effects of positive and negative family relationship quality on health and well-being differ in the context of varying levels of positive friend relationships. Data were from two waves (1992/1993 and 2005) of the Social Relations, Aging and Health Study. The sample included respondents aged 18 and older at Wave 1 who reported having a best friend at both waves (N = 455), and consisted of 291 (64%) women and 164 (36%) men. Wave 1 friend positivity and family positivity interacted to predict self-rated health but not self-esteem, indicating that among respondents with a less positive friend relationship, more positive family relationships were related to worse health at Wave 2. Wave 1 friend positivity and family negativity significantly interacted to predict self-rated health and self-esteem at Wave 2. The nature of the interactions were consistent in that among respondents with a more highly positive friend relationship, less negative family relationships were linked to better health and self-esteem at Wave 2. Findings provide insight into the complex way in which social relations impact positive outcomes in adulthood. Previous studies have documented the consistent and straightforward manner in which negative relationships impact health and well-being, whereas this study illustrates that the role of positive social relations is more variable and dependent on multiple relationship contexts. PMID:24273462

  3. Strategies to teach family assessment and intervention through an online international curriculum.

    Science.gov (United States)

    Anderson, Kathryn Hoehn; Friedemann, Marie-Luise

    2010-05-01

    A Web-based certificate program for international health professionals to acquire understanding of family health and strategies to implement culturally sensitive health care of families is outlined. In four Web courses and a project, students progress interactively to apply culture, family, and interdisciplinary health system theories to assessments and clinical interventions with families in the interdisciplinary setting. Four online educational strategies to facilitate student success from the virtual classroom to actual clinical care are described: adjusting to the technology, communicating the learning progress openly, giving mutual feedback, and implementing evidence-based family care. Outcomes addressing student learning and skill enhancement, family interaction, and student and faculty experiences in the virtual learning environment are explored. Overall, students learned to work successfully with families in health care, experienced increasing comfort and competency in challenging situations, introduced family care in their work setting, and emerged as leaders while working in interdisciplinary teams.

  4. Evidence-Based Family Interventions for Adolescents and Young Adults With Bipolar Disorder.

    Science.gov (United States)

    Miklowitz, David J

    2016-01-01

    An individual can develop bipolar disorder at any age, but emergence during adolescence and young adulthood can lead to a number of problematic behaviors and outcomes. Several drugs are available as first-line treatments, but even optimal pharmacotherapy rarely leads to complete remission and recovery. When added to pharmacologic treatment, certain targeted psychosocial treatments can improve outcomes for young patients with bipolar disorder. Because bipolar disorder affects family members as well as patients, and because adolescents and young adults often live with and are dependent on their parents, the patient's family should usually be included in treatment. Family-focused treatment and dialectical behavior therapy are promising methods of conducting family intervention. With effective treatment and the support of their families, young patients with bipolar disorder can learn to manage their disorder and become independent and healthy adults. © Copyright 2016 Physicians Postgraduate Press, Inc.

  5. Lost in translation - the role of family in interventions among adults with diabetes; a systematic review

    DEFF Research Database (Denmark)

    Torenholt, Rikke; Schwennesen, Nete; Willaing, Ingrid

    2014-01-01

    Aims Family interventions are increasingly recognized as important in the care of people with diabetes. The aim of this study was to synthesize the existing literature on family interventions among adults with Type 1 and Type 2 diabetes and to determine the degree to which they were family centred....... Methods The literature search was carried out in four databases (Scopus, CINAHL, PsycINFO and ERIC). Two reviewers independently screened the search results. Only English-language articles about interventions on education, care and/or support of adult individuals with diabetes involving the participation...... of both the individual with diabetes and at least one family member were included. Results From an initial 1480 citations, 10 reports were included. The intervention studies varied considerably in terms of design and population. The family dimension generally represented a modest part of the interventions...

  6. Correlates of Objective Social Isolation from Family and Friends among Older Adults

    Science.gov (United States)

    Chatters, Linda M.; Taylor, Harry Owen; Taylor, Robert Joseph

    2018-01-01

    This study examined the correlates of objective social isolation from extended family members and friends among older adults. The analysis is based on the older adult sub-sample of the National Survey of American Life (n = 1321). Multinomial logistic regression analyses examined race/ethnicity, demographics, functional health and family and friend network factors as correlates of objective isolation from family and friends. Only 4.47% of respondents were objectively isolated from both their extended family and friends, 10.82% were isolated from their friends, and 7.43% were isolated from their family members. Men were more likely to be objectively isolated from both family and friends and older adults who live with others were significantly more likely to be objectively isolated from their friends. When controlling for subjective social isolation, the two measures of functional health were significantly associated with objective social isolation. In particular, higher levels of self-care impairment decreased the risk of being objectively isolated from friends only, whereas higher mobility impairment was associated with an increased likelihood of being objectively isolated from friends only. Subjective evaluations of social isolation from family and friends were consistently associated with being objectively isolated from family and friends. There were no significant differences between African-Americans, Black Caribbeans and non-Hispanic Whites in objective isolation. These and other findings are discussed in detail. PMID:29510504

  7. Correlates of Objective Social Isolation from Family and Friends among Older Adults.

    Science.gov (United States)

    Chatters, Linda M; Taylor, Harry Owen; Nicklett, Emily J; Taylor, Robert Joseph

    2018-03-03

    This study examined the correlates of objective social isolation from extended family members and friends among older adults. The analysis is based on the older adult sub-sample of the National Survey of American Life ( n = 1321). Multinomial logistic regression analyses examined race/ethnicity, demographics, functional health and family and friend network factors as correlates of objective isolation from family and friends. Only 4.47% of respondents were objectively isolated from both their extended family and friends, 10.82% were isolated from their friends, and 7.43% were isolated from their family members. Men were more likely to be objectively isolated from both family and friends and older adults who live with others were significantly more likely to be objectively isolated from their friends. When controlling for subjective social isolation, the two measures of functional health were significantly associated with objective social isolation. In particular, higher levels of self-care impairment decreased the risk of being objectively isolated from friends only, whereas higher mobility impairment was associated with an increased likelihood of being objectively isolated from friends only. Subjective evaluations of social isolation from family and friends were consistently associated with being objectively isolated from family and friends. There were no significant differences between African-Americans, Black Caribbeans and non-Hispanic Whites in objective isolation. These and other findings are discussed in detail.

  8. Family Conflicts and Violence against Women - An International Comparison

    Czech Academy of Sciences Publication Activity Database

    Rendlová, Eliška

    2002-01-01

    Roč. 1, č. 3 (2002), s. 6-8 ISSN 1213-9920 R&D Projects: GA AV ČR IBS7028205 Institutional research plan: CEZ:AV0Z7028912 Keywords : public opinion * family conflicts * violence against women Subject RIV: AO - Sociology, Demography

  9. A bequest from the Bene family | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Born in Vienna and raised in Hungary, where his family owned a plywood factory, ... Bene was one of the founders of the Children's Foundation and a Director of the ... Bene had a deep confidence in people and recognized the importance of ...

  10. International Population Assistance and Family Planning Programs: Issues for Congress

    National Research Council Canada - National Science Library

    Nowels, Larry; Veillette, Connie

    2006-01-01

    Since 1965, U.S. policy has supported international population planning based on principles of volunteerism and informed choice that gives participants access to information on all methods of birth control...

  11. International Population Assistance and Family Planning Programs: Issues for Congress

    National Research Council Canada - National Science Library

    Blanchfield, Luisa

    2008-01-01

    Since 1965, the U.S. Government has supported international population planning based on principles of volunteerism and informed choice that gives participants access to information on all methods of birth control...

  12. Daily Family Interactions among Young Adults in the United States from Latin American, Filipino, East Asian, and European Backgrounds

    Science.gov (United States)

    Fuligni, Andrew; Masten, Carrie L.

    2010-01-01

    In contrast to the abundant research on family relationships during adolescence, the nature of family interactions during young adulthood remains comparatively unexamined. The current study explored ethnic differences in young adults' interactions with parents and siblings, the role of other activities in young adults' family interactions, and the…

  13. An international collaborative family-based whole genome quantitative trait linkage scan for myopic refractive error

    DEFF Research Database (Denmark)

    Abbott, Diana; Li, Yi-Ju; Guggenheim, Jeremy A

    2012-01-01

    To investigate quantitative trait loci linked to refractive error, we performed a genome-wide quantitative trait linkage analysis using single nucleotide polymorphism markers and family data from five international sites....

  14. Life Satisfaction among Young Adults from Rural Families.

    Science.gov (United States)

    Wilson, Stephan M.; Peterson, Gary W.

    1988-01-01

    Examined possible predictors of life satisfaction among 322 low-income young adults from rural Appalachia. Both objective and subjective conditions of life were predictors of life satisfaction: financial resources, self-esteem, and proximity to childhood home were positive predictors; frustrations about limited job opportunities and community size…

  15. Family support and blood pressure pattern in adult patients ...

    African Journals Online (AJOL)

    Data was collected using a structured questionnaire and family APGAR questionnaire. The diagnosis of hypertension was based on blood pressure (BP) threshold of 140/90 mmHg according to JNC VII guidelines definitions. Data was analyzed using Stata statistical software (Version 10). Results: The mean age and BP of ...

  16. The Interplay of Work-Family Life and Psychosocial Adjustment for International Graduate Students

    OpenAIRE

    Bulgan, Gökçe; Çiftçi, Ayşe

    2017-01-01

    The purpose of this paper is to critically review the literature on the interplay of work-family life and psychosocial adjustment of married international graduate students to the United States, provide evidence for a complicated and integrated support mechanism for married international graduate students, and make specific recommendations. Empirical studies on student and expatriate work-family life and psychosocial adjustment are reviewed. Studies indicated a significant negative relationsh...

  17. Community-Level Characteristics Associated With Variation in Rates of Homelessness Among Families and Single Adults

    Science.gov (United States)

    Fargo, Jamison D.; Munley, Ellen A.; Byrne, Thomas H.; Montgomery, Ann Elizabeth; Culhane, Dennis P.

    2013-01-01

    Objectives. We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. Methods. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Results. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Conclusions. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations. PMID:24148057

  18. Community-level characteristics associated with variation in rates of homelessness among families and single adults.

    Science.gov (United States)

    Fargo, Jamison D; Munley, Ellen A; Byrne, Thomas H; Montgomery, Ann Elizabeth; Culhane, Dennis P

    2013-12-01

    We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations.

  19. An Integrated Framework for Effective and Efficient Communication with Families in the Adult Intensive Care Unit.

    Science.gov (United States)

    Seaman, Jennifer B; Arnold, Robert M; Scheunemann, Leslie P; White, Douglas B

    2017-06-01

    The increased focus on patient and family-centered care in adult intensive care units (ICUs) has generated multiple platforms for clinician-family communication beyond traditional interdisciplinary family meetings (family meetings)-including family-centered rounds, bedside or telephone updates, and electronic family portals. Some clinicians and administrators are now using these platforms instead of conducting family meetings. For example, some institutions are moving toward using family-centered rounds as the main platform for clinician-family communication, and some physicians rely on brief daily updates to the family at the bedside or by phone, in lieu of family meetings. We argue that although each of these platforms is useful in some circumstances, there remains an important role for family meetings. We outline five goals of clinician-family communication-establishing trust, providing emotional support, conveying clinical information, understanding the patient as a person, and facilitating careful decision making-and we examine the extent to which various communication platforms are likely to achieve the goals. We argue that because no single platform can achieve all communication goals, an integrated strategy is needed. We present a model that integrates multiple communication platforms to effectively and efficiently support families across the arc of an ICU stay. Our framework employs bedside/telephone conversations and family-centered rounds throughout the admission to address high informational needs, along with well-timed family meetings that attend to families' emotions as well as patients' values and goals. This flexible model uses various communication platforms to achieve consistent, efficient communication throughout the ICU stay.

  20. Narratives of family members on the suicide of older adults in an Amazonian metropolis.

    Science.gov (United States)

    Costa, André Luis Sales da; Souza, Maximiliano Loiola Ponte de

    2017-12-11

    To analyze the narratives of family members on the suicide of older adults in Manaus, State of Amazonas, Brazil. This is a qualitative study of the narratives of eight older adults, who committed suicide in the period of 2001-2012. In the analytic-interpretative process, we have tried to perform the hermeneutic double exercise: to interpret the interpretation of narrators. We have used as theoretical references authors who have investigated suicide from the perspective of gender and its correlations with the sociofamiliar context and with mental disorders. The family members would conceive the suicide of the older adults as related to losses, which would occur in a strained sociofamiliar scenario, leading to the appearance of psychopathological situations that, if not properly followed, would result in death. There would also be something inexorable in this sequence of events. The older adults, by the very time of their life, would tend to accumulate losses of different aspects in their trajectory. Their rigor and other relational limitations would simultaneously stress family relationships, favoring conflicts, and hinder adherence to treatment. This model of understanding, which has a wide support in the hegemonic medical-psychological discourse, in a sense minimizes possible self- or heteroaccusations directed at family members. Special attention should be given to identify the older adults who present losses, family conflicts, and signs of psychopathology and who do not follow-up psychosocial care services. Strategies to help older adults handle family conflicts and losses, empowering them, should be developed and made available by intersectoral actions. The adequate treatment of psychopathological conditions should be implanted in a context in which active search mechanisms also existed for older adults who abandoned follow-up. The implementation of these actions is a challenge to be faced in Manaus, State of Amazonas, Brazil, where there is a low availability

  1. Family Caregiver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults With Cancer.

    Science.gov (United States)

    Geddie, Patricia I; Wochna Loerzel, Victoria; Norris, Anne E

    2016-07-01

    To explore factors related to unplanned hospital admissions and determine if one or more factors are predictive of unplanned hospital admissions for older adults with cancer.
. A prospective longitudinal design and a retrospective chart review.
. Adult oncology outpatient infusion centers and inpatient units at Orlando Regional Medical Center in Florida.
. A convenience sample of 129 dyads of older adults with cancer and their family caregivers. 
. Family caregiver demographic and side effect knowledge data were collected prospectively during interviews with family caregivers using a newly developed tool, the Nurse Assessment of Family Caregiver Knowledge and Action Tool. Patient demographic and clinical data were obtained through a retrospective chart review. Descriptive statistics and logistic regression analyses were used to evaluate data and examine relationships among variables.
. Patient illness characteristics; impaired function; side effects, such as infection, fever, vomiting, and diarrhea; family caregiver knowledge; and unplanned hospital admissions.
. Unplanned hospital admissions were more likely to occur when older adults had impaired function and side effects, such as infection, fever, vomiting, and diarrhea. Impaired function and family caregiver knowledge did not moderate the effects of these side effects on unplanned hospital admissions. 
. Findings suggest that the presence of impaired function and side effects, such as infection, fever, vomiting, and diarrhea, predict unplanned hospital admissions in older adults with cancer during the active treatment phase. Side effects may or may not be related to chemotherapy and may be related to preexisting comorbidities. 
. Nurses can conduct targeted assessments to identify older adults and their family caregivers who will need additional follow-up and support during the cancer treatment trajectory. Information gained from these assessments will assist nurses to provide practical and

  2. Ethnic Differences in Relations between Family Process and Child Internalizing Problems

    Science.gov (United States)

    Vendlinski, Matthew; Silk, Jennifer S.; Shaw, Daniel S.; Lane, Tonya J.

    2006-01-01

    Background: Family process variables have been linked to child problem behavior, but recent research suggests that child ethnicity may moderate relations between family process and child outcomes. The current study examined how ethnicity moderates relations between parent conflict, parent-child relationship quality, and internalizing problems.…

  3. Physical family violence and externalizing and internalizing behaviors among children and adolescents.

    Science.gov (United States)

    Renner, Lynette M; Boel-Studt, Shamra

    2017-01-01

    Family violence has been associated with various negative outcomes among children and adolescents. Yet, less is known about how unique forms of physical family violence contribute to externalizing and internalizing behaviors based on a child's developmental stage. Using data from the Illinois Families Study and administrative Child Protective Services data, we explored the relation between 3 types of physical family violence victimization and externalizing and internalizing behaviors among a sample of 2,402 children and adolescents. After including parent and family level covariates in Poisson regressions, we found that a unique form of family violence victimization was associated with increased externalizing behaviors among children at each age group: exposure to physical intimate partner violence (IPV) among children ages 3-5, exposure to the physical abuse of a sibling among children ages 6-12, and child physical abuse among adolescents ages 13-18. No form of physical family violence was significantly associated with internalizing behaviors for children in any age group. Including exposure to the child maltreatment of a sibling is crucial when attempting to contextualize children's responses to family violence and providing comprehensive services in an effort to enhance the well-being of all children in a family. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Relationships among the perceived health status, family support and life satisfaction of older Korean adults.

    Science.gov (United States)

    Kim, Sook-Young; Sok, Sohyune R

    2012-08-01

    The objective of this study was to examine the perceived health status, family support and life satisfaction of older Korean adults and the relationships among them. This study was designed to be a descriptive correlation study using questionnaire. Subjects were 246 older people who were over 65 years of age in Seoul and Daegu metropolitan city, Korea. Measures were the Cornell Medical Index-Simple Korean Form to measure the perceived health status, the Family Support Instrument to measure the family support and the Standard Life Satisfaction Instrument for Korean people to measure the life satisfaction. Perceived health state was worse as average 3.3, family support was good as average 3.4 and life satisfaction was low as average 3.1. There were statistically significant positive correlations among perceived health state, family support and life satisfaction and between family support and life satisfaction. The predictors of life satisfaction in elderly were family support, age, monthly allowance and perceived health state. These factors explained 37.5% of the total variance. The major influencing factor was family support. This cross-sectional study provides preliminary evidence that to develop nursing strategy to increase family support of older Korean adults is needed. © 2012 Blackwell Publishing Asia Pty Ltd.

  5. Retrospective reports of parenting received in their families of origin: relationships to adult attachment in adult children of alcoholics.

    Science.gov (United States)

    Kelley, Michelle L; Nair, Veena; Rawlings, Tanaya; Cash, Thomas F; Steer, Kate; Fals-Stewart, William

    2005-09-01

    The present study examined general and romantic attachment and parenting students received in their families of origin among 401 college students who resided with an alcohol-abusing parent prior to age 16 years as compared to those who did not reside with alcohol-abusing parents. Participants completed the Children's Report of Parent Behavior Instrument [Schludermann, E. and Schludermann, S. (1970). Children's Report of Parent Behavior Inventory (CRPBI). Canada: University of Manitoba], Experiences in Close Relationships--Revised [Fraley, R. C., Waller, N. G., and Brennan, K. G. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78, 350-365], Relationship Scale Questionnaire [Griffin, D. W. and Bartholomew, K. (1994). Models of the self and other: Fundamental dimensions underlying measures of adult attachment. Journal of Personality and Social Psychology, 67, 430-445], and the Children of Alcoholics Screening Test [Jones, J. W. (1983). The Children of Alcoholics Screening Test: Test manual. Chicago: Camelot]. Young adults who met criteria for ACOAs reported more anxious and avoidant behavior in romantic relationships and a more fearful style of general adult attachment. Parenting behavior in one's family of origin predicted anxious behavior in romantic relationships and a fearful overall style of attachment, whereas being an ACOA and parenting in one's family of origin predicted avoidant behavior in romantic relationships.

  6. Internal market orientation and work-family balance in family businesses

    OpenAIRE

    Ruizalba, J; Soares, A; Vallespín, M; González Porras, J

    2016-01-01

    This research paper aims at investigating the importance of work---family balance (WFB) on family businesses from Andalusia (Spain) and its impact on job satisfaction and employees’ commitment. The research objectives are twofold: (1) to classify companies based on the level of WFB implementation; (2) to investigate the differences between groups of companies in relation to job satisfaction, commitment, firm size and generation. In order to achieve these objectives an empirical study was cond...

  7. Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.

    Science.gov (United States)

    Williams, Brent C; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg Mpa, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G; Leipzig, Rosanne M

    2010-09-01

    Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory

  8. The mourning before: can anticipatory grief theory inform family care in adult intensive care?

    Science.gov (United States)

    Coombs, Maureen A

    2010-12-01

    Although anticipatory grief is a much-debated and critiqued bereavement concept, it does offer a way of understanding and exploring expected loss that may be helpful in certain situations. In end-of-life care in adult intensive care units, families often act as proxy decision makers for patients in the transition from curative treatment efforts to planned treatment withdrawal. Despite there being a developed evidence base to inform care of families at this time, few of the clinical studies that provided this evidence were underpinned by bereavement theory. Focusing on end-of-life intensive care practices, this paper integrates work on anticipatory grief and family interventions to present a family-centred framework of care. Through this it is argued that the complex needs of families must be more comprehensively understood by doctors and nurses and that interventions must be more systematically planned to improve quality end-of-life care for families in this setting.

  9. Transformative Learning through International Immersion: Building Multicultural Competence in Family Therapy and Counseling

    Science.gov (United States)

    McDowell, Teresa; Goessling, Kristen; Melendez, Tatiana

    2012-01-01

    This study explores the experiences of graduate students who completed one of two international courses facilitated by family therapy faculty in a U.S. master's-level counseling psychology department. Participants reported that international courses were personally and professionally transformative. Spending time in a foreign country gave them…

  10. Daily well-being of older adults with friends and family.

    Science.gov (United States)

    Larson, R; Mannell, R; Zuzanek, J

    1986-06-01

    Family members are the major source of physical and emotional support for older adults, yet researchers suggest that friendships have a stronger bearing on subjective well-being. In this research we sought an explanation for this inconsistency in older adults' immediate experiences with friends. Retired adults provided self-reports on their subjective states at random moments during a typical week. Analyses of these reports confirmed the prediction that older adults have more favorable experiences with their friends than with family members. The difference is partly attributable to the greater frequency of active leisure activities with friends, but is also due to unique qualities of interactions with friends that facilitate transcendence of mundane daily realities. We propose that friends provide an immediate situation of openness, reciprocity, and positive feedback that engenders enjoyment and subjectively meaningful exchanges.

  11. The experiences of Cypriot hearing adults with Deaf parents in family, school, and society.

    Science.gov (United States)

    Hadjikakou, Kika; Christodoulou, Despina; Hadjidemetri, Eleni; Konidari, Maria; Nicolaou, Nicoletta

    2009-01-01

    This paper investigates the personal experiences of hearing adults with signing Deaf parents in their families, school, and society. In order to obtain relevant information, in-depth semi-structured interviews were conducted with 10 Cypriot hearing adults with Deaf parents between the ages of 21 and 30 years with different occupation, sex, and educational background. It was found that most of the participants developed a bicultural identity, undertook the interpreter and protector role in their family, and interacted well with their parents, despite the lack of in-depth communication that they noted. The positive role of the extended family was acknowledged. The prejudices of Cypriot hearing people against the Deaf people were identified, as well as the lack of state support toward the Deaf community. This study has implications for Deaf parents, and professionals working, planning, and implementing social, psychological, and educational support services to Deaf-parented families.

  12. Diagnostic and Statistical Manual of Mental Disorders-5: implications for older adults and their families.

    Science.gov (United States)

    Sorrell, Jeanne M

    2013-03-01

    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is targeted for publication in May 2013. Older adults and their families should be aware of the potential impact that changes in this important document may have on diagnosis and treatment of mental health concerns. Two specific changes related to a new category of Neurocognitive Disorders and a new interpretation of criteria for depression after bereavement are discussed in this article. Nurses can help older adults and their families understand the new DSM-5 terminology and encourage them to discuss risks, benefits, and likely outcomes of diagnoses, procedures, and treatments that may seem unfamiliar. Copyright 2013, SLACK Incorporated.

  13. Family history of type 2 diabetes and prevalence of metabolic syndrome in adult Asian Indians.

    Science.gov (United States)

    Das, Mithun; Pal, Susil; Ghosh, Arnab

    2012-04-01

    Our objective was to test the association between familial risk of type 2 diabetes mellitus (T2DM) and the prevalence of metabolic syndrome (MS) in adult Asian Indians. A total of 448 adult (>30 years) individuals (257 males and 191 females) participated in the study. Familial risk of T2DM was classified into three groups viz., 1=both parents affected; 2=parent and/or siblings affected and 3=none or no family history for T2DM. Anthropometric measures, blood pressures, fasting blood glucose and metabolic profiles were studied using standard techniques. MS was defined accordingly. The prevalence of MS phenotypes was estimated and compared among the three familial risk strata. Individuals with a history of both parents affected from diabetes had significantly higher (Pfamily history of T2DM. Significant difference was also noticed between individuals with and without MS according to the family history of diabetes (Pfamily history of T2DM. Family history of T2DM had significant effect on individuals with MS as compared to their counterparts (individuals having no family history of T2DM). It therefore seems reasonable to argue that family history of T2DM could be useful as a predictive tool for early diagnosis and prevention of MS in Asian Indian population.

  14. The process of death imminence awareness by family members of patients in adult critical care.

    Science.gov (United States)

    Baumhover, Nancy C

    2015-01-01

    A focus on cost-effective quality end-of-life care remains a high priority in adult critical care given an aging population, high prevalence of death, and aggressive technologies used to extend or sustain life in this setting. A Glaserian grounded theory design was used to conduct this retrospective study to yield a substantive middle-range theory. The data source was semistructured interviews with 14 family members of decedents who died 6 to 60 months prior to the study. The purpose of this study was to generate a theory on how family members of patients in adult critical care come to realize that their loved one is dying. The Process of Death Imminence Awareness by Family Members of Patients in Adult Critical Care middle-range theory contained 6 phases: (1) patient's near-death awareness, (2) dying right in front of me, (3) turning points in the patient's condition, (4) no longer the person I once knew, (5) doing right by them, and (6) time to let go. Patient's near-death awareness preceded all other phases, if communicated by the decedent with their family. Then, family members iteratively moved through all the other key phases in the process until a time to let go became evident. This substantive middle-range theory will guide nursing education, practice, and research aimed at providing quality and cost-effective end-of-life care in adult critical care.

  15. Counting Family: Making the Family of International Students Visible in Higher Education Policy and Practice

    Science.gov (United States)

    Doyle, Stephanie; Loveridge, Judith; Faamanatu-Eteuati, Niusila

    2016-01-01

    This article focuses on a significant group of postgraduate international students overlooked by institutions and policymakers, namely those with accompanying partners and children. The economic importance of international students to Australia, Canada, New Zealand, the United Kingdom, and the United States of America is highlighted. It is argued…

  16. Protective Factors Against the Impact of School Bullying Perpetration and Victimization on Young Adult Externalizing and Internalizing Problems.

    Science.gov (United States)

    Hemphill, Sheryl A; Tollit, Michelle; Herrenkohl, Todd I

    2014-01-01

    School-based bullying perpetration and victimization is common worldwide and has profound impacts on student behavior and mental health. However, few studies have examined young adult outcomes of bullying perpetration or victimization. Research on factors that protect students who have bullied or been bullied is also lacking. This study examined young adult externalizing and internalizing problems (aged 18-19 years) and adolescent protective factors related to self-reported bullying perpetration and victimization among over 650 Victorians aged 16-17 years. Opportunities for prosocial involvement in the family lessened subsequent involvement in nonviolent antisocial behavior, as an outcome of prior bullying. High academic performance and having strategies to cope with stress reduced young adult depressive symptoms for participants who had been victims of bullying. The implications for bullying prevention and early intervention programs are discussed.

  17. Validity and reliability of the Family Empowerment Scale for caregivers of adults with mental health issues.

    Science.gov (United States)

    Kageyama, M; Nakamura, Y; Kobayashi, S; Yokoyama, K

    2016-10-01

    WHAT IS KNOWN ON THE SUBJECT?: Empowerment of family caregivers of adults with mental health issues has received increasing attention among mental health nurses in Japan and has been recognized as a new goal of family interventions. The Family Empowerment Scale (FES) was originally developed to measure the empowerment status of parents of children with emotional disorders. However, it was later applied to broader health issues. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We developed a Japanese version of the FES for family caregivers of adults with mental health issues (FES-AMJ) and examined the validity and reliability among parents. Results showed that the FES-AMJ had acceptable concurrent validity and reliability; however, insufficient construct validity was found, especially for the subscale regarding the service system. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further studies need to modify the scale. Clarification of ideal family empowerment status in the service system through discussion with mental health nurses and family caregivers may be important. Introduction The Family Empowerment Scale (FES) was originally developed for parents of children with emotional disorders. In Japan, family empowerment is gaining increasing attention and may be one goal of nursing interventions. Aim To develop a Japanese version of the FES for family caregivers of adults with mental health issues and to study the validity and reliability of this scale among parents. Method We translated the FES into Japanese and administered this self-report questionnaire to 275 parents. Results The multitrait scaling analysis revealed acceptable convergent validity and insufficient discriminant validity among all subscales. In particular, all items of the Service system subscale had insufficient discriminant and/or convergent validity. Each subscale significantly correlated with the indicator of empowerment. The intraclass correlation coefficients of each subscale were .855-.917. Cronbach

  18. Empowerment of family caregivers of adults and elderly persons: A concept analysis.

    Science.gov (United States)

    Sakanashi, Sayori; Fujita, Kimie

    2017-10-01

    This concept analysis defined and described the components of empowerment of family caregivers who care for adults and the elderly. Rodgers evolutionary method of concept analysis was used. Data sources included Pub Med, CINAHL, Scopus, and Igaku Chuo Zasshi. Thirty articles published between 1995 and 2015 focusing on the empowerment of family caregivers providing care to adults and the elderly were selected. The analysis reveals 6 attributes, 5 antecedents, and 5 consequences. In addition, the results reveal structured aspects of family caregivers, care receivers, and other people surrounding them, and their relationships. Empowerment of adults' and elders' family caregivers may be defined as "positive control of one's mind and body, cultivating a positive attitude, proactively attempting to understand one's role as a caregiver to improve caregiving capabilities, focusing on others as well as oneself, supporting the independence of the care receiver, and creating constructive relationships with other people surrounding them." The components of empowerment clarified in this research can be used for the measurement of and interventions aimed at improving empowerment among family caregivers. Furthermore, clarifying the definition of empowerment among family caregivers enables researchers to better distinguish empowerment from similar concepts in the future. © 2017 John Wiley & Sons Australia, Ltd.

  19. Sex education and family planning services for young adults: alternative urban strategies in Mexico.

    Science.gov (United States)

    Townsend, J W; Diaz de May, E; Sepúlveda, Y; Santos de Garza, Y; Rosenhouse, S

    1987-01-01

    In Mexico, youth face difficulties in obtaining reliable information on sex education and family planning through existing community programs. Two alternative strategies to provide these services are being tested in poor urban areas of Monterrey. In one experimental area, Integrated Youth Centers were established, which provide sex education and family planning services as well as counseling, academic tutoring, and recreational activities. In another area, trained young adults and community counselors work through informal networks to provide sex education and family planning information. Both utilization and the cost of these services are examined in the context of plans for expanding coverage in Mexico-U.S. border areas.

  20. Education for Internationalism at the Nordic School for Adult Education in Geneva 1931-1939

    Science.gov (United States)

    Leppanen, Katarina

    2011-01-01

    Internationalism in the interwar era carried different meaning for different groups. A Nordic school for adult education, with the aim of raising the "international citizenship proficiency" of the Nordic peoples, was established in Geneva in 1931, through cooperation between representatives of international organisations and adult…

  1. From early family systems to internalizing symptoms: The role of emotion regulation and peer relations.

    Science.gov (United States)

    Lindblom, Jallu; Vänskä, Mervi; Flykt, Marjo; Tolvanen, Asko; Tiitinen, Aila; Tulppala, Maija; Punamäki, Raija-Leena

    2017-04-01

    Research has demonstrated the importance of early family characteristics, such as the quality of caregiving, on children's later mental health. Information is, however, needed about the role of more holistic family systems and specific child-related socioemotional mechanisms. In this study, we conceptualize families as dynamic family system types, consisting of both marital and parenting trajectories over the transition to parenthood. First, we examine how early family system types predict children's anxiety, depression, peer exclusion, and emotion regulation. Second, we test whether couples' infertility history and other family related contextual factors moderate the effects of family system types on child outcomes. Third, we test whether children's emotion regulation and peer exclusion mediate the effects of family system types on anxiety and depression. The participants were 452 families representing cohesive, distant, authoritative, enmeshed, and discrepant family types, identified on the basis of relationship autonomy and intimacy from pregnancy to the child's age of 2 and 12 months. Children's anxiety, depression, emotion regulation, and peer exclusion were assessed at the age of 7-8 years. Structural equation modeling showed that distant, enmeshed, and discrepant families similarly predicted children's heightened anxiety and depression. Infertility history, parental education, and parity moderated the associations between certain family system types and child outcomes. Finally, emotion regulation, but not peer exclusion, was a common mediating mechanism between distant and enmeshed families and children's depression. The results emphasize the importance of early family environments on children's emotion regulation development and internalizing psychopathology. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Food and Nutrition Practices and Education Needs in Florida's Adult Family Care Homes

    Science.gov (United States)

    Dahl, Wendy J.; Ford, Amanda L.; Gal, Nancy J.

    2014-01-01

    A statewide survey was carried out to determine food and nutrition practices and education needs of Florida's adult family care homes (AFCHs). The 30-item survey included questions on food and nutrition education, supplement use, and menu planning. Infrequent use of menus and nutrition supplements was reported. A strong need was indicated for…

  3. Adult Children of Dysfunctional Families: Treatment from a Disenfranchised Grief Perspective.

    Science.gov (United States)

    Zupanick, Corinne E.

    1994-01-01

    Generalizes concept of disenfranchised grief to understanding of recovery process for adult children of dysfunctional families. Describes recovery process of this population as parallel to grief process. Identifies two layers of unrecognized loss: loss of one's childhood and loss of one's fantasized and idealized parent. Suggests specific…

  4. Prevalence of family violence in adults and children : Estimates using the capture-recapture method

    NARCIS (Netherlands)

    Oosterlee, A.; Vink, R.M.; Smit, F.

    2009-01-01

    Background: Reliable prevalence estimates of family violence in adults and children are difficult to obtain. Most are based on surveys or registration counts, whose research designs and methods are often questionable, making the results difficult to compare. This article presents an alternative

  5. Transition Satisfaction and Family Well Being among Parents of Young Adults with Severe Intellectual Disability

    Science.gov (United States)

    Neece, Cameron L.; Kraemer, Bonnie R.; Blacher, Jan

    2009-01-01

    The transition from high school to adulthood is a critical life stage that entails many changes, especially for youth with severe intellectual disability. The transition period may be especially stressful for the families of these young adults, who often experience a sudden change, or decrease, in services. However, little research has examined…

  6. Performance Monitoring Is Altered in Adult ADHD: A Familial Event-Related Potential Investigation

    Science.gov (United States)

    McLoughlin, Grainne; Albrecht, Bjoern; Banaschewski, Tobias; Rothenberger, Aribert; Brandeis, Daniel; Asherson, Philip; Kuntsi, Jonna

    2009-01-01

    Background: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that starts in childhood and frequently persists in adults. Electrophysiological studies in children with ADHD provide evidence for abnormal performance monitoring processes and familial association of these processes with ADHD. It is not yet known…

  7. Digital Storytelling in Adult Education and Family Literacy: A Case Study from Rural Ireland

    Science.gov (United States)

    Prins, Esther

    2017-01-01

    Previous research on digital storytelling (DST) has focused chiefly on children and youth, but we know little about how it is used in non-formal adult education. This article analyzes a DST class in rural Ireland, which was organized by a family literacy program and offered for parents at an elementary school. Data sources included fieldnotes,…

  8. Evaluation of 28 years of surgical treatment of children and young adults with familial adenomatous polyposis

    NARCIS (Netherlands)

    Booij, Klaske A. C.; Mathus-Vliegen, Elisabeth M. H.; Taminiau, Jan A. J. M.; ten Kate, Fibo J. W.; Slors, J. Frederick M.; Tabbers, Merit M.; Aronson, Daniel C.

    2010-01-01

    Background: In this retrospective study, 28 years of surgical treatment of children and young adults with familial adenomatous polyposis (FAP) was analyzed. Methods: Forty-three patients were operated on before the age of 26 years. Endoscopic aspects, operative data, and complications were analyzed,

  9. Evaluation of 28 years of surgical treatment of children and young adults with familial adenomatous polyposis.

    NARCIS (Netherlands)

    Booij, K.A.; Mathus-Vliegen, E.M.H.; Taminiau, J.A.; Kate, F.J. ten; Slors, J.F.M.; Tabbers, M.M.; Aronson, D.C.

    2010-01-01

    BACKGROUND: In this retrospective study, 28 years of surgical treatment of children and young adults with familial adenomatous polyposis (FAP) was analyzed. METHODS: Forty-three patients were operated on before the age of 26 years. Endoscopic aspects, operative data, and complications were analyzed,

  10. Patterns of family health history communication among older African American adults.

    Science.gov (United States)

    Hovick, Shelly R; Yamasaki, Jill S; Burton-Chase, Allison M; Peterson, Susan K

    2015-01-01

    This qualitative study examined patterns of communication regarding family health history among older African American adults. The authors conducted 5 focus groups and 6 semi-structured interviews with African Americans aged 60 years and older (N = 28). The authors identified 4 distinct patterns of family health history communication: noncommunication, open communication, selective communication (communication restricted to certain people or topics), and one-way communication (communication not reciprocated by younger family members). In general, participants favored open family health history communication, often resulting from desires to change patterns of noncommunication in previous generations regarding personal and family health history. Some participants indicated that they were selective about what and with whom they shared health information in order to protect their privacy and not worry others. Others described family health history communication as one-way or unreciprocated by younger family members who appeared uninterested or unwilling to share personal and family health information. The communication patterns that the authors identified are consistent with communication privacy management theory and with findings from studies focused on genetic testing results for hereditary conditions, suggesting that individuals are consistent in their communication of health and genetic risk information. Findings may guide the development of health message strategies for African Americans to increase family health history communication.

  11. Gender Differences in Adult Health: An International Comparison.

    Science.gov (United States)

    Rahman, Omar; And Others

    1994-01-01

    Used data from United States, Jamaica, Malaysia, and Bangladesh to explore gender differences in adult health. Found that women fared worse than men across variety of self-reported health measures in all four countries. Data from Jamaica indicated that gender disparities in adult health arose early and persisted throughout the life cycle, with…

  12. Radiation Treatment for Ewing Family of Tumors in Adults: University of Florida Experience

    International Nuclear Information System (INIS)

    Shi Wenyin; Indelicato, Daniel J.; Keole, Sameer R.; Morris, Christopher G.; Scarborough, Mark T.; Gibbs, Parker C.; Zlotecki, Robert A.

    2008-01-01

    Purpose: To review the clinical characteristics and outcomes of adult patients with Ewing family of tumors treated with radiation at University of Florida. Methods and Materials: Clinical features, treatment, and outcomes of 47 patients older than 18 years with Ewing family of tumors treated with combined radiation therapy and chemotherapy from 1970 to 2005 were retrospectively reviewed. Analysis was stratified by age older or younger than 30 years. Patients with metastatic disease at the time of diagnosis were excluded from the study. Results: The 29 men and 18 women had a median age of 24 years. Thirty-three patients were 18-30 years old and 14 patients were older than 30 years. Median follow-up of living patients was 8.2 years. The 5-year overall survival rate for all patients was 43% (p = 0.8523). The 5-year local control rate for all patients was 75% (p = 0.9326). The 5-year rate of freedom from distant metastasis for all patients was 45% (p = 0.5471). There were no significant differences in 5-year overall survival, local control, and freedom from distant metastasis rates; patterns of distant failure; or toxicity profiles between older adult patients and younger adult patients. Conclusions: We found that the natural history and treatment outcomes of the Ewing family of tumors were consistently similar in adults (young and old) and children. Thus, aggressive combined modality approaches should be considered for adult patients

  13. Fatigue in family caregivers of adult intensive care unit survivors.

    Science.gov (United States)

    Choi, JiYeon; Tate, Judith A; Hoffman, Leslie A; Schulz, Richard; Ren, Dianxu; Donahoe, Michael P; Given, Barbara A; Sherwood, Paula R

    2014-09-01

    Family caregivers are a vital resource in the recovery of intensive care unit (ICU) survivors. Of concern, the stress associated with this role can negatively affect caregiver health. Fatigue, an important health indicator, has been identified as a predictor of various illnesses, greater use of health services, and early mortality. Examining the impact of fatigue on caregivers' physical health can assist in identifying critical time points and potential targets for intervention. To describe self-reported fatigue in caregivers of ICU survivors from patients' ICU admission to ≤ 2 weeks, two- and four-months post-ICU discharge. Patient-caregiver pairs were enrolled from a medical ICU. Caregiver fatigue was measured using the Short-Form 36 Health Survey Vitality subscale (SF-36 Vitality). Caregiver psychobehavioral stress responses included depressive symptoms, burden, health risk behaviors, and sleep quality. Patient data included self-reported physical symptoms and disposition (home vs. institution). Forty-seven patient-caregiver pairs were initially enrolled. Clinically significant fatigue (SF-36 Vitality ≤ 45) was reported by 43%-53% of caregivers across the time points, and these caregivers reported worse scores in measures of depressive symptoms, burden, health risk behaviors and sleep quality, and patients' symptom burden. In 26 caregivers with data for all time points (55% of the total sample), SF-36 Vitality scores showed trends of improvement when the patient returned home and greater impairment when institutionalization continued. In caregivers of ICU survivors, fatigue is common and potentially linked with poor psychobehavioral responses. Worsening fatigue was associated with greater symptom distress and long-term patient institutionalization. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  14. Childhood family disruption and adult height: is there a mediating role of puberty?

    Science.gov (United States)

    Sheppard, Paula; Garcia, Justin R; Sear, Rebecca

    2015-11-24

    Childhood family background is known to be associated with child growth and development, including the onset of puberty, but less is known about the influence of childhood family disruption on outcomes in later life. Given the associations between early family disruption and childhood development, we predicted that there may be long-term health-relevant consequences of childhood disruption. Using data from a large US interview sample (n = 16 207), we test if death or divorce of parents, at different childhood periods, was associated with adult stature, and whether age at puberty mediated this relationship, for men and women. RESULTS MEN: : parental death and divorce during early childhood was associated with shorter adult height, and later puberty. Later puberty was associated with shorter adult height. Path analyses demonstrated that the relationship between parental divorce and height was completely mediated by age at puberty; although parental death was only partially mediated by age at puberty. WOMEN: the father's death during early childhood was associated with earlier puberty, which was in turn associated with shorter adult stature. The relationship between paternal death and height is entirely mediated by age at puberty; no evidence of a direct relationship between childhood family disruption and adult height. Early childhood familial disruption is associated with shorter height for men, and is partially mediated by later puberty. For women, the relationship between father's death, and height was completely mediated by earlier puberty. These findings indicate that disruption during childhood can have long-reaching health repercussions, particularly for boys. © The Author(s) 2015. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.

  15. Internalized stigma in adults with early phase versus prolonged psychosis.

    Science.gov (United States)

    Firmin, Ruth L; Lysaker, Paul H; Luther, Lauren; Yanos, Philip T; Leonhardt, Bethany; Breier, Alan; Vohs, Jenifer L

    2018-03-30

    Although internalized stigma is associated with negative outcomes among those with prolonged psychosis, surprisingly little work has focused on when in the course of one's illness stigma is internalized and the impact of internalization on symptoms or social functioning over the course of the illness. Therefore, this study investigated whether (1) internalized stigma is greater among those later in the course of psychosis and (2) whether internalized stigma has a stronger negative relationship with social functioning or symptoms among those with prolonged compared to early phase psychosis. Individuals with early phase (n = 40) and prolonged psychosis (n = 71) who were receiving outpatient services at an early-intervention clinic and a VA medical center, respectively, completed self-report measures of internalized stigma and interview-rated measures of symptoms and social functioning. Controlling for education, race and sex differences, internalized stigma was significantly greater among those with prolonged psychosis compared to early phase. Internalized stigma was negatively related to social functioning and positively related to symptoms in both groups. Furthermore, the magnitude of the relationship between cognitive symptoms and internalized stigma was significantly greater among those with early phase. Stereotype endorsement, discrimination experiences and social withdrawal also differentially related to symptoms and social functioning across the 2 samples. Findings suggest that internalized stigma is an important variable to incorporate into models of early psychosis. Furthermore, internalized stigma may be a possible treatment target among those with early phase psychosis. © 2018 John Wiley & Sons Australia, Ltd.

  16. Rights and the Role of Family Engagement in Child Welfare: An International Treaties Perspective on Families' Rights, Parents' Rights, and Children's Rights

    Science.gov (United States)

    Lenzer, Gertrud; Gran, Brian

    2011-01-01

    According to international human rights treaties, what rights do family members, parents, and children have in family engagement in child welfare decision-making? A sociolegal analytical approach produces a typology of rights, then applies the typology to eight countries' approaches to family engagement to show that strong bundles of rights are…

  17. Family process and youth internalizing problems: A triadic model of etiology and intervention.

    Science.gov (United States)

    Schleider, Jessica L; Weisz, John R

    2017-02-01

    Despite major advances in the development of interventions for youth anxiety and depression, approximately 30% of youths with anxiety do not respond to cognitive behavioral treatment, and youth depression treatments yield modest symptom decreases overall. Identifying networks of modifiable risk and maintenance factors that contribute to both youth anxiety and depression (i.e., internalizing problems) may enhance and broaden treatment benefits by informing the development of mechanism-targeted interventions. A particularly powerful network is the rich array of family processes linked to internalizing problems (e.g., parenting styles, parental mental health problems, and sibling relationships). Here, we propose a new theoretical model, the triadic model of family process, to organize theory and evidence around modifiable, transdiagnostic family factors that may contribute to youth internalizing problems. We describe the model's implications for intervention, and we propose strategies for testing the model in future research. The model provides a framework for studying associations among family processes, their relation to youth internalizing problems, and family-based strategies for strengthening prevention and treatment.

  18. Why Do Children from Socioeconomically Disadvantaged Families Suffer from Poor Health When They Reach Adulthood? A Life-Course Study. : Childhood socioeconomic disadvantage and adult disorders

    OpenAIRE

    Melchior , Maria; Moffitt , Terrie ,; Milne , Barry ,; Poulton , Richie; Caspi , Avshalom

    2007-01-01

    International audience; The authors investigated what risk factors contribute to an excess risk of poor adult health among children who experience socioeconomic disadvantage. Data came from 1,037 children born in Dunedin, New Zealand, in 1972-1973, who were followed from birth to age 32 years (2004-2005). Childhood socioeconomic status (SES) was measured at multiple points between birth and age 15 years. Risk factors evaluated included a familial liability to poor health, childhood/adolescent...

  19. Narratives of family members on the suicide of older adults in an Amazonian metropolis

    Directory of Open Access Journals (Sweden)

    André Luis Sales da Costa

    2017-12-01

    Full Text Available ABSTRACT OBJECTIVE To analyze the narratives of family members on the suicide of older adults in Manaus, State of Amazonas, Brazil. METHODS This is a qualitative study of the narratives of eight older adults, who committed suicide in the period of 2001-2012. In the analytic-interpretative process, we have tried to perform the hermeneutic double exercise: to interpret the interpretation of narrators. We have used as theoretical references authors who have investigated suicide from the perspective of gender and its correlations with the sociofamiliar context and with mental disorders. RESULTS The family members would conceive the suicide of the older adults as related to losses, which would occur in a strained sociofamiliar scenario, leading to the appearance of psychopathological situations that, if not properly followed, would result in death. There would also be something inexorable in this sequence of events. The older adults, by the very time of their life, would tend to accumulate losses of different aspects in their trajectory. Their rigor and other relational limitations would simultaneously stress family relationships, favoring conflicts, and hinder adherence to treatment. This model of understanding, which has a wide support in the hegemonic medical-psychological discourse, in a sense minimizes possible self- or heteroaccusations directed at family members. CONCLUSIONS Special attention should be given to identify the older adults who present losses, family conflicts, and signs of psychopathology and who do not follow-up psychosocial care services. Strategies to help older adults handle family conflicts and losses, empowering them, should be developed and made available by intersectoral actions. The adequate treatment of psychopathological conditions should be implanted in a context in which active search mechanisms also existed for older adults who abandoned follow-up. The implementation of these actions is a challenge to be faced in

  20. Boomerang families and failure-to-launch: Commentary on adult children living at home.

    Science.gov (United States)

    Burn, Katherine; Szoeke, Cassandra

    2016-01-01

    With a shifting economic climate and changes in social norms, young adults are increasingly reported to be living with their parents, either through delayed launch or by launch and return. For young adults grappling with financial and domestic independence, the family home can represent a safe haven; however, living with parents can also pose a threat to autonomy and self-image as they strive for adult status. Parents, on the other hand, are often beleaguered by the economic and emotional demands of their dependent adult children and struggle to maintain their own independence. The roles and expectations of both parties need to be redefined in order to achieve optimal household functioning. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Ethnic differences in family trajectories of young adult women in the Netherlands : Timing and sequencing of events

    NARCIS (Netherlands)

    Kleinepier, T.; van de Valk, H.A.G.

    2016-01-01

    Background: Despite extensive research on the family behavior of young adults, family dynamics of children of migrants remain largely unexplored. This is unfortunate as family transitions are strongly interlinked with transitions in other domains (e.g., education, work) and predictive for outcomes

  2. De-standardization of family-life trajectories of young adults: a cross-national comparison using sequence analysis

    NARCIS (Netherlands)

    Elzinga, C.; Liefbroer, A.C.

    2007-01-01

    We introduce a number of new methods based on sequence analysis to test hypotheses on the de-standardization of family-life trajectories in early adulthood, using Fertility and Family Survey data on 19 countries. Across cohorts, family-life trajectories of young adults have not become more

  3. De-standardization of family-life trajectories of young adults: A cross-national comparison using sequence analyses

    NARCIS (Netherlands)

    Elzinga, C.H.; Liefbroer, A.C.

    2007-01-01

    We introduce a number of new methods based on sequence analysis to test hypotheses on the de-standardization of family-life trajectories in early adulthood, using Fertility and Family Survey data on 19 countries. Across cohorts, family-life trajectories of young adults have not become more

  4. Relationships in the Coda (Child of deaf adult family [Relacje w rodzinie CODA

    Directory of Open Access Journals (Sweden)

    Iwona JAGOSZEWSKA

    2017-11-01

    Full Text Available Human existence is accompanied by attempts at self understanding, finding one’s place in the world and a way to co-exist with other people. The very unique social and family situation of the hearing children of deaf parents allows the trials of clarification of what characterizes and distingishes them as Codas. The childhood, adolescence and adult life of Codas is definitely different than the lives of people living in hearing families. In the family in which one or both parents are deaf it is very likely that the way they are functioning will have consequences for their hearing childrens' future functioning. There are aspects of family life that have influence on this disguised difference, such as: forms of communication, pantomimic gestures, mimics and also the characteristic phenomena of family roles reversal. The relations in Codas untypical families are determined by multiple factors. Among them mutual understanding which, with the help of values presented and applied in the process of upbringing, is one of the most important as it may result, in the right circumstances, in achieving a unique family union. The forming of emotional bonds between deaf parents and their children is influenced by, for example fulfilling the need of love in the family house and the adequate use of situations which favour communication. Usually the perspective of time makes adult Codas more tolerant and fully understanding of the obligations assigned to them by deaf parents during their childhood and adolescence. Being a Coda each time is related to individual life situations in which some Codas may find themselves happy and fulfilled while others won’t .

  5. Family environment and adult resilience: contributions of positive parenting and the oxytocin receptor gene

    Directory of Open Access Journals (Sweden)

    Bekh Bradley

    2013-09-01

    Full Text Available Background: Abundant research shows that childhood adversity increases the risk for adult psychopathology while research on influences of positive family environment on risk for psychopathology is limited. Similarly, a growing body of research examines genetic and gene by environment predictors of psychopathology, yet such research on predictors of resilience is sparse. Objectives: We examined the role of positive factors in childhood family environment (CFE and the OXTR rs53576 genotype in predicting levels of adult resilient coping and positive affect. We also examined whether the relationship between positive factors in the CFEs and adult resilient coping and positive affect varied across OXTR rs53576 genotype. Methods: We gathered self-report data on childhood environment, trauma history, and adult resilience and positive affect in a sample of 971 African American adults. Results: We found that positive CFE was positively associated with higher levels of resilient coping and positive affect in adulthood after controlling for childhood maltreatment, other trauma, and symptoms of posttraumatic stress disorder. We did not find a direct effect of OXTR 53576 on a combined resilient coping/positive-affect-dependent variable, but we did find an interaction of OXTR rs53576 with family environment. Conclusions: Our data suggest that even in the face of adversity, positive aspects of the family environment may contribute to resilience. These results highlight the importance of considering protective developmental experiences and the interaction of such experiences with genetic variants in risk and resilience research.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  6. Internalized Stigma and Perceived Family Support in Acute Psychiatric In-Patient Units.

    Science.gov (United States)

    Korkmaz, Gülçin; Küçük, Leyla

    2016-02-01

    This descriptive study aims to identify the relationship between internalized stigma and perceived family support in patients hospitalized in an acute psychiatric unit. The sample is composed of 224 patients treated in an acute inpatient psychiatric ward in İstanbul, Turkey. The data were collected using information obtained from the Internalized Stigma of Mental Illness Scale and Social Support from Family Scale. The mean age of the patients was 37±11.56years, and the mean duration of treatment was 6.27±5.81years. Most patients had been hospitalized three or more times. Of the total number of patients, 66.1% had been taken to the hospital by family members. We noted a statistically significant negative correlation between the total scores obtained from the perceived Social Support from Family Scale and the Internalized Stigma of Mental Illness Scale. The patients were observed to stigmatize themselves more when the perceived social support from their family had decreased. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Capturing Between- and Within-Family Differences in Parental Support to Adult Children: A Typology Approach.

    Science.gov (United States)

    Kim, Kyungmin; Fingerman, Karen L; Birditt, Kira S; Zarit, Steven H

    2016-11-01

    Families differ widely in the support they provide to adult offspring, both with regard to the overall level as well as the extent to which support is evenly distributed across offspring. This study addressed these dynamics by creating family profiles based on the average level and differentiation of support among children. We also examined demographic and psychological factors that predict typology membership. We utilized data from 431 middle-aged parents (aged 40-60) with at least two adult children. Parents provided separate ratings of support given to each child. Latent profile analysis was applied to two indicators of within-family support: mean level and differentiation among offspring. Latent profile analysis identified four patterns of parental support: (a) high support-low differentiation (52%), (b) medium support-high differentiation (26%), (c) low support-low differentiation (17%), and (d) low support-very high differentiation (5%). These patterns reflected distinct family characteristics, such as parental resources, parental beliefs (i.e., equal treatment, obligation), and offspring characteristics. Our findings emphasize the need to capture dynamics of support exchanges among multiple offspring at the level of family. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. A review of issues and concerns of family members of adult burn survivors.

    Science.gov (United States)

    Sundara, Diana C

    2011-01-01

    The purpose of this review is to synthesize what is known about the issues and concerns of families of adult burn survivors from research and clinical articles written between 1973 and 2009. Electronic database searching, ancestry searching, and electronic hand searching were performed to identify relevant articles. Seventeen research studies and 14 clinical articles were identified. Families are often in crisis immediately after the injury. This crisis involves strong emotions, some of which may persist over time. Throughout the course of hospitalization, family issues include worries about their loved one's physical appearance, logistical concerns, and the transition to home. For partners, role changes and sexual concerns may be of particular importance. Extended family, friends, the burn team, and other families affected by a burn injury are important sources of support for family members. Few studies have been conducted beyond the time of hospitalization. Clinical articles have identified issues not present in the research literature. Further research is needed that focuses more closely on families and their experiences both in and out of the hospital. Implications for burn care providers based on the findings of this review are discussed.

  9. Patterns of family management for adolescent and young adult brain tumor survivors.

    Science.gov (United States)

    Deatrick, Janet A; Barakat, Lamia P; Knafl, George J; Hobbie, Wendy; Ogle, Sue; Ginsberg, Jill P; Fisher, Michael J; Hardie, Thomas; Reilly, Maureen; Broden, Elizabeth; Toth, Jennifer; SanGiacomo, Nicole; Knafl, Kathleen A

    2018-04-01

    Little is known about how families systemically incorporate the work of caring for adolescent and young adult (AYA) survivors of childhood brain tumors who often remain dependent on their families well into adulthood. The primary aim of this study was to develop a typology of family management (FM) patterns for AYA survivors. The secondary aims were to compare them with FM patterns previously described for children with chronic health conditions and to validate the patterns using quantitative and qualitative data. Guided by the Family Management Styles Framework, a sequential, mixed-methods design was used to gather quantitative data from 186 mothers (primary caregivers) and 134 AYA survivors. FM patterns (family focused; somewhat family focused; somewhat condition focused; and condition focused) were identified using cluster analysis of data from the Family Management Measure. FM patterns were found to be similar to those for children with chronic health physical conditions and were significantly related to maternal quality of life, survivor quality of life (health-related quality of life [self- and mother proxy report]), cancer-related variables (treatment intensity, medical late effects), and family functioning in theoretically meaningfully ways. Significant demographic characteristics included private insurance and AYA survivors' engagement in school or employment. Qualitative analysis of data from 45 interviews with mothers from the larger sample provided additional support for and elaborated descriptions of FM patterns. Identification of FM patterns moves the science of family caregiving forward by aggregating data into a conceptually based typology, thereby taking into account the complex intersection of the condition, the family, and condition management. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. International Perspectives on Work-Family Policies: Lessons from the World's Most Competitive Economies

    Science.gov (United States)

    Earle, Alison; Mokomane, Zitha; Heymann, Jody

    2011-01-01

    The United States does not guarantee families a wide range of supportive workplace policies such as paid maternity and paternity leave or paid leave to care for sick children. Proposals to provide such benefits are invariably met with the complaint that the costs would reduce employment and undermine the international competitiveness of American…

  11. Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

    Science.gov (United States)

    Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

    2001-01-01

    Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

  12. Work-Family Balance and Psychosocial Adjustment of Married International Students

    OpenAIRE

    Gökçe Bulgan; Ayşe Çiftçi

    2018-01-01

    The authors investigated how work-family balance mediated the relationship between personality traits, gender roles, social support, and psychosocial adjustment. Data were collected from 243 married international graduate students (MIGSs) studying in the United States. Results of structural equation modeling indicated that personality traits influence the psychosocial adjustment process. In addition, being extraverted, agreeable, and conscientious contributed to balanc...

  13. Internalized Stigma of Mental Illness among Schizophrenic Patients and Their Families (Comparative Study)

    Science.gov (United States)

    Mahmoud, Sahar; Zaki, Rania A.

    2015-01-01

    This study was a comparative study aiming to assess the extent of internalized stigma of mental illness among patients with schizophrenia & identify stigma as perceived by family members caring schizophrenic patients. The study was conducted in two settings 1st clinic was outpatient clinic for psychiatric patient affiliated to Abbasia…

  14. Personality traits of a group of young adults from different family structures.

    Science.gov (United States)

    Du Toit, J; Nel, E M; Steel, H R

    1992-07-01

    The impact of parental divorce and remarriage and young adults' gender on second-order personality traits, such as extraversion, anxiety, tough poise and independence, was examined. The responses of 227 young adults on the Sixteen Personality Factor Questionnaire (16PF; Cattell, Eber, & Tatsuoka, 1970) were subjected to a parametric multivariate analysis of variance. Results revealed significant differences between the anxiety scores of the young men and women as well as between those of the three different family-structure groups, but divorce and remarriage was not associated with either positive or negative personality development in this sample.

  15. Family relationships, quality of life and social competence in Colombian adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Sonia Carrillo

    2013-08-01

    Full Text Available The main purpose of this study was to assess the infl uence of family relationships on two central aspects of individual functioning: social competence and quality of life in a sample of 103 Colombian adolescents and young adults. Results revealed different signifi cant associations for men and women between the study variables (relationships with parents and sibling, quality of life and social competence. Results are discussed based on the literature on differential effects of family relationships on adolescents’ and young adults’ psychological and social well-being.

  16. The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement.

    Science.gov (United States)

    Bower, Wendy F; Christie, Deborah; DeGennaro, Mario; Latthe, Pallavi; Raes, Ann; Romao, Rodrigo L P; Taghizadeh, Arash; Wood, Dan; Woodhouse, Christopher R J; Bauer, Stuart B

    2017-03-01

    Children with urinary tract disorders managed by teams, or individual pediatricians, urologists, nephrologists, gastroenterologists, neurologists, psychologists, and nurses at some point move from child-centered to adult-centered health systems. The actual physical change is referred to as the transfer whilst the process preceding this move constitutes transition of care. Our aims are twofold: to identify management and health-service problems related to children with congenital or acquired urological conditions who advance into adulthood and the clinical implications this has for long-term health and specialist care; and, to understand the issues facing both pediatric and adult-care clinicians and to develop a systems-approach model that meets the needs of young adults, their families and the clinicians working within adult services. Information was gleaned from presentations at an International Children's Continence Society meeting with collaboration from the International Continence Society, that discussed problems of transfer and transitioning such children. Several specialists attending this conference finalized this document identifying issues and highlighting ways to ease this transition and transfer of care for both patients and practitioners. The consensus was, urological patients with congenital or other lifelong care needs, are now entering adulthood in larger numbers than previously, necessitating new planning processes for tailored transfer of management. Adult teams must become familiar with new clinical problems in multiple organ systems and anticipate issues provoked by adolescence and physical growth. During this period of transitional care the clinician or team assists young patients to build attitudes, skills and understanding of processes needed to maximize function of their urinary tract-thus taking responsibility for their own healthcare needs. Preparation must also address, negotiating adult health care systems, psychosocial, educational or

  17. Young adult international adoptees' search for birth parents.

    Science.gov (United States)

    Tieman, Wendy; van der Ende, Jan; Verhulst, Frank C

    2008-10-01

    This study examines international adoptees and factors associated with searching for birth parents. A total of 1,417 international adoptees in The Netherlands, aged 24 to 30 years, were divided into 4 groups: uninterested nonsearchers, interested nonsearchers, searchers, and reunited searchers. In total, 32% of adoptees had searched. Although the majority of searchers were well-adjusted, they had more problems--mainly internalizing problems--than uninterested nonsearchers. These problems, however, were not caused by the search itself. It is concluded that searching is the product of natural curiosity influenced by external factors such as the divorce of adoptive parents and the options for searching. Copyright 2008 APA, all rights reserved.

  18. External and Internal Sport Motivations of Young Adults

    Science.gov (United States)

    Bollok, Sandor; Takacs, Johanna; Kalmar, Zsuzsanna; Dobay, Beata

    2011-01-01

    Study aim: To determine and evaluate the spectrum of sport motivation of young adults. Material and methods: A group of 600 subjects, aged 17-19 years, participated in the study. An "ad hoc" questionnaire was applied to assess the 4 motivational factors: competition and success-oriented motivation, external accommodation, physical…

  19. Television, Home-Cooked Meals, and Family Meal Frequency: Associations with Adult Obesity.

    Science.gov (United States)

    Tumin, Rachel; Anderson, Sarah E

    2017-06-01

    Adults, regardless of whether they are parents, regularly eat meals with family at home, but few studies have analyzed large, population-based samples to examine how mealtime practices or family meal frequency are associated with health. The aim of this study was to evaluate associations between the frequency of family meals eaten at home, watching television or videos during family meals, and consumption of meals that were cooked and eaten at home and the odds of being obese in adults. This was an analysis of the cross-sectional 2012 Ohio Medicaid Assessment Survey (OMAS), a telephone survey of Ohio's population. The study sample was adult Ohio residents responding to the 2012 OMAS who ate at least one family meal in the past week (n=12,842). Obesity (body mass index [BMI] ≥30), calculated from self-reported height and weight, was the outcome. Logistic regression models were used to examine the association between obesity and family meal practices, adjusted for respondents' employment status, marital status, race/ethnicity, educational attainment, and age. Family meal frequency was not associated with odds of obesity: those who ate family meals most (6-7) days were as likely as those who ate family meals few (1-2) days to be obese (adjusted odds ratio [OR adj ]=1.01, 95% CI=0.86, 1.18). Thirty-six percent of adults never watched television or videos while eating family meals, and 62% ate family meals that were all home-cooked. Adults who never watched television or videos during family meals had 37% lower odds of obesity compared with those who always did (95% CI=0.54, 0.73), regardless of family meal frequency. Adults whose family meals were all home-cooked had 26% lower odds of obesity than those who ate some or no home-cooked family meals (95% CI=0.62, 0.88). This association was more pronounced among adults who ate few family meals. Family meal practices may be associated with obesity in adults, even if they eat few family meals per week. Future research

  20. Parental divorce: long-term effects on mental health, family relations and adult sexual behavior.

    Science.gov (United States)

    Jónsson, F H; Njardvik, U; Olafsdóttir, G; Grétarsson, S J

    2000-06-01

    Specific long term effects of parental divorce were examined in a sample of 179 Icelanders, 20 to 30 years of age. The participants answered the Borromean Family Index, the Affect Balance Scale and a number of questions on sexual behavior and attitudes towards marriage and divorce. Results showed that compared to adults whose parents remained married, those of divorced parents reported more negative emotional experiences at the time of the study and had looser family ties. They also had greater number of short love affairs, had their first love affair at a younger age, had a greater number of sexual partners, and were younger at the time of their first sexual intercourse than adults whose parents remained married.

  1. Comparison of health care needs of child family members of adults with alcohol or drug dependence versus adults with asthma or diabetes.

    Science.gov (United States)

    Ray, G Thomas; Mertens, Jennifer R; Weisner, Constance

    2014-05-01

    To compare the health problems, preventive care utilization, and medical costs of child family members (CFMs) of adults diagnosed with alcohol or drug dependence (AODD) to CFMs of adults diagnosed with diabetes or asthma. Child family members of adults diagnosed with AODD between 2002 and 2005 and CFMs of matched adults diagnosed with diabetes or asthma were followed up to 7 years after diagnosis of the index adult. Logistic regression was used to determine whether the CFMs of AODD adults were more likely to be diagnosed with medical conditions, or get preventive care, than the CFMs of adults with asthma or diabetes. Children's health services use was compared using multivariate models. In Year 5 after index date, CFMs of adults with AODD were more likely to be diagnosed with depression and AODD than CFMs of adults with asthma or diabetes and were less likely to be diagnosed with asthma, otitis media, and pneumonia than CFMs of adults with asthma. CFMs of AODD adults were less likely than CFMs of adult asthmatic patients to have annual well-child visits. CFMs of AODD adults had similar mean annual total health care costs to CFMs of adults with asthma but higher total costs ($159/yr higher, confidence interval, $56-$253) than CFMs of adult diabetic patients. CFMs of adults with AODD had higher emergency department, higher outpatient alcohol and drug program, higher outpatient psychiatry, and lower primary care costs than CFMs of either adult asthmatic patients or diabetic patients. Children in families with an alcohol- or drug-dependent adult have unique patterns of health conditions, and differences in the types of health services used, compared to children in families with an adult asthmatic or diabetic family member. However, overall cost and utilization for health care services is similar or only somewhat higher. This is the first study of its kind, and the results have implications for the reduction of parental alcohol or drug dependence stigma by health care

  2. Finding Family Balance: Establishing an Adult Relationship with the Person with a Disability (A Pamphlet for Families) [and] Equilibrio Familiar: Como Establecer una Relacion Adulta con la Persona con Impedimentos (Panfleto para la Familia).

    Science.gov (United States)

    Baron, Carla

    Two booklets, in English and Spanish, are addressed to families of disabled adults and offer guidelines for establishing an adult relationship with the disabled individual within the family. Stressed are the importance of helping the disabled adult develop a positive self image, learning to truly listen to the adult as part of improving…

  3. Organ S values and effective doses for family members exposed to adult patients following I-131 treatment: A Monte Carlo simulation study

    Energy Technology Data Exchange (ETDEWEB)

    Han, Eun Young [Department of Radiation Oncology, University of Arkansas Medical Sciences, Little Rock, Arkansas 72205 (United States); Lee, Choonsik [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, Maryland 20852 (United States); Mcguire, Lynn; Brown, Tracy L. Y. [Department of Radiology, Division of Nuclear Medicine, University of Arkansas Medical Sciences, Little Rock, Arkansas 72205 (United States); Bolch, Wesley E. [J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida 32611 (United States)

    2013-08-15

    Purpose: To calculate organ S values (mGy/Bq-s) and effective doses per time-integrated activity (mSv/Bq-s) for pediatric and adult family members exposed to an adult male or female patient treated with I-131 using a series of hybrid computational phantoms coupled with a Monte Carlo radiation transport technique.Methods: A series of pediatric and adult hybrid computational phantoms were employed in the study. Three different exposure scenarios were considered: (1) standing face-to-face exposures between an adult patient and pediatric or adult family phantoms at five different separation distances; (2) an adult female patient holding her newborn child, and (3) a 1-yr-old child standing on the lap of an adult female patient. For the adult patient model, two different thyroid-related diseases were considered: hyperthyroidism and differentiated thyroid cancer (DTC) with corresponding internal distributions of {sup 131}I. A general purpose Monte Carlo code, MCNPX v2.7, was used to perform the Monte Carlo radiation transport.Results: The S values show a strong dependency on age and organ location within the family phantoms at short distances. The S values and effective dose per time-integrated activity from the adult female patient phantom are relatively high at shorter distances and to younger family phantoms. At a distance of 1 m, effective doses per time-integrated activity are lower than those values based on the NRC (Nuclear Regulatory Commission) by a factor of 2 for both adult male and female patient phantoms. The S values to target organs from the hyperthyroid-patient source distribution strongly depend on the height of the exposed family phantom, so that their values rapidly decrease with decreasing height of the family phantom. Active marrow of the 10-yr-old phantom shows the highest S values among family phantoms for the DTC-patient source distribution. In the exposure scenario of mother and baby, S values and effective doses per time-integrated activity to

  4. Organ S values and effective doses for family members exposed to adult patients following I-131 treatment: A Monte Carlo simulation study

    International Nuclear Information System (INIS)

    Han, Eun Young; Lee, Choonsik; Mcguire, Lynn; Brown, Tracy L. Y.; Bolch, Wesley E.

    2013-01-01

    Purpose: To calculate organ S values (mGy/Bq-s) and effective doses per time-integrated activity (mSv/Bq-s) for pediatric and adult family members exposed to an adult male or female patient treated with I-131 using a series of hybrid computational phantoms coupled with a Monte Carlo radiation transport technique.Methods: A series of pediatric and adult hybrid computational phantoms were employed in the study. Three different exposure scenarios were considered: (1) standing face-to-face exposures between an adult patient and pediatric or adult family phantoms at five different separation distances; (2) an adult female patient holding her newborn child, and (3) a 1-yr-old child standing on the lap of an adult female patient. For the adult patient model, two different thyroid-related diseases were considered: hyperthyroidism and differentiated thyroid cancer (DTC) with corresponding internal distributions of 131 I. A general purpose Monte Carlo code, MCNPX v2.7, was used to perform the Monte Carlo radiation transport.Results: The S values show a strong dependency on age and organ location within the family phantoms at short distances. The S values and effective dose per time-integrated activity from the adult female patient phantom are relatively high at shorter distances and to younger family phantoms. At a distance of 1 m, effective doses per time-integrated activity are lower than those values based on the NRC (Nuclear Regulatory Commission) by a factor of 2 for both adult male and female patient phantoms. The S values to target organs from the hyperthyroid-patient source distribution strongly depend on the height of the exposed family phantom, so that their values rapidly decrease with decreasing height of the family phantom. Active marrow of the 10-yr-old phantom shows the highest S values among family phantoms for the DTC-patient source distribution. In the exposure scenario of mother and baby, S values and effective doses per time-integrated activity to the

  5. Screening of a healthy newborn identifies three adult family members with symptomatic glutaric aciduria type I

    Directory of Open Access Journals (Sweden)

    MCH Janssen

    2014-06-01

    Full Text Available We report three adult sibs (one female, two males with symptomatic glutaric acidura type I, who were diagnosed after a low carnitine level was found by newborn screening in a healthy newborn of the women. All three adults had low plasma carnitine, elevated glutaric acid levels and pronounced 3-hydroxyglutaric aciduria. The diagnosis was confirmed by undetectable glutaryl-CoA dehydrogenase activity in lymphocytes and two pathogenic heterozygous mutations in the GCDH gene (c.1060A>G, c.1154C>T. These results reinforce the notion that abnormal metabolite levels in newborns may lead to the diagnosis of adult metabolic disease in the mother and potentially other family members.

  6. Helping older adults to help themselves: the role of mental health literacy in family members.

    Science.gov (United States)

    White, Margaret; Casey, Leanne

    2017-11-01

    Family members may play an important role in the health and well-being of older adults. However, little is known about the factors that influence the likelihood of family members supporting older relatives to seek help from mental health professionals for mental health concerns. Mental health literacy is associated with people's help-seeking intentions regarding their own mental health concerns, and some studies have suggested it may play a role in help-seeking on behalf of others. The purpose of this study was to investigate whether mental health literacy is associated with adults' likelihood of supporting an older relative to seek professional help for mental health concerns. Two hundred and sixty-three participants completed a measure of mental health literacy and responded to a hypothetical scenario by indicating their likelihood of supporting an older relative experiencing mental health problems to seek help from various sources. Mental health literacy was positively associated with intentions to support older relative's help-seeking. Interventions to increase the mental health literacy of the relatives of older adults may lead to additional support for older adults' help-seeking for mental health concerns.

  7. Differential Effects of Family Structure on Religion and Spirituality of Emerging Adult Males and Females.

    Science.gov (United States)

    Handal, Paul J; Lace, John W

    2017-08-01

    This study examined measures of religion and spirituality in a sample of male and female emerging adult college students whose parents were either divorced or intact using the Personal Religious Inventory, the Duke University Religion Index, the Daily Spiritual Experiences Scale, the Spiritual Transcendence Scale, and the Spiritual Involvement and Beliefs Scale. Data were collected online, and 66% of participants received extra credit for participating. A main effect of sex was found, as females reported significantly higher scores than men on all but one measure of religion and spirituality, and the dataset was separated by sex. No differences were found between males from divorced and intact families. However, females from intact families scored significantly higher on all religion and spirituality measures than females from divorced families. This study suggests that females may respond differently than males to their parents' divorce in the context of religion and spirituality, and discusses possible reasons.

  8. Increased clinical anticipation with maternal transmission in benign adult familial myoclonus epilepsy in Japan.

    Science.gov (United States)

    Hitomi, Takefumi; Kobayashi, Katsuya; Jingami, Naoto; Nakagawa, Tomokazu; Imamura, Hisaji; Matsumoto, Riki; Kondo, Takayuki; Chin, Kazuo; Takahashi, Ryosuke; Ikeda, Akio

    2013-12-01

    We recently reported clinical anticipation in Japanese families with benign adult familial myoclonus epilepsy (BAFME). However, it remains unknown whether clinical anticipation is predominantly associated with paternal or maternal transmission. We investigated the relationship between gender of the transmitting parent and clinical anticipation in nine BAFME families. Clinical anticipation regarding either cortical tremor or generalised seizures was observed in all 12 parent/child pairs (8 mother/child pairs and 4 father/child pairs). Moreover, a higher degree of clinical anticipation was associated with maternal transmission than with paternal transmission (p=0.03). Although a causative gene for BAFME still remains unknown, our finding suggests that BAFME and diseases with unstable expanding repeats, including those in non-coding regions, might share a similar molecular mechanism because such diseases often show clinical anticipation with maternal transmission.

  9. The role of family decision in internal migration: the case of India.

    Science.gov (United States)

    Bhattacharyya, B

    1985-01-01

    This paper analyzes the effects of family decisions and individual decisions on rural-urban migration in India under 2 different rural institutions--family farm and wage labor systems. An analytical framework for explaining family migration decisions reveals that whenever a member of the extended family migrates, he gives up his share in the produce of the family farm. When this happens, the number of adult members on the farm goes down and the total product is affected. 3 case studies of Indian villages are analyzed for this study. 2 empirical relations are examined: 1) if individual migration decisions are predominant, and 2) if family decisions are important in determining the overall flow of migration. Relationships between migration decisions and other variables, such as: 1) number of males in urban areas; 2) urban wages; 3) daily wage rate; 4) average agricultural income; 5) railway distance between rural and urban areas; 6) size of the labor market in destination region; 7) probability that a migrant arriving in an urban area will find a job; and 8) comsumption expenditure, in urban areas estimated by working class consumer price index, are determined. Results show that: 1) the market determined wage variable does not play a very significant role in migration decisions; 2) distance is one of the most important variables in analyzing migration; and 3) the aggregate flow of migration is affected if migration decisions are predominantly family decisions. These findings have relevant policy implications for less developed countries (LDCs), especially because large flows of rural-urban migration in recent years have forced governments to adopt policies for controlling the flows to reduce the burden of unemployment in the urban areas. Government policies affecting rural institutions will have an impact on migration flow; those that lead to a reduction of uncertainty in agriculture will affect average per-capita consumption levels in family farms and hence

  10. Transmission of infectious diseases from internationally adopted children to their adoptive families.

    Science.gov (United States)

    Sciauvaud, J; Rigal, E; Pascal, J; Nourrisson, C; Poirier, P; Poirier, V; Vidal, M; Mrozek, N; Laurichesse, H; Beytout, J; Labbe, A; Lesens, O

    2014-08-01

    Internationally adopted children may suffer from different pathologies, including infectious diseases contracted in the country of origin. We evaluated the frequency of infectious diseases that may disseminate from adoptees to adoptive families on their arrival in France. All children who attended the clinic for international adoption in Clermont-Ferrand from January 2009 through to December 2011 were eligible for inclusion in the study. Standardized medical records dedicated to international adoption were retrospectively reviewed for demographic data, clinical diagnosis, and biological and radiological results. Data were completed by phone interviews with adoptive families after informed consent. One hundred and forty-two medical records were retrospectively reviewed and 86% of families agreed to be interviewed. One hundred and seventy-one potentially transmissible infections were diagnosed in 142 children, 12% (n = 20) of which were transmitted to adoptive families. Most of these infections were benign and transmission was restricted to the close family. Tinea was diagnosed in 44 adoptees and transmitted in 15 cases. Panton Valentine leukocidin producing methicillin-sensitive S. aureus (MSSA) was transmitted to an adoptive father who required hospitalization for bursitis. Transmission also occurred for CMV (n = 1), hepatitis A (n = 1), giardiasis (n = 1), scabies (n = 1), Moluscum (n = 2) and pediculosis (n = 2). Two cases of chronic hepatitis B and latent tuberculosis were diagnosed without subsequent transmission. In conclusion, infectious diseases are common in internationally adopted children and should be detected shortly after arrival to avoid transmission. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  11. Spouses of older adults with late-life drinking problems: health, family, and social functioning.

    Science.gov (United States)

    Moos, Rudolf H; Brennan, Penny L; Schutte, Kathleen K; Moos, Bernice S

    2010-07-01

    This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms. Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or follow-up, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning. At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking. Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves. Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits.

  12. Spouses of Older Adults With Late-Life Drinking Problems: Health, Family, and Social Functioning*

    Science.gov (United States)

    Moos, Rudolf H.; Brennan, Penny L.; Schutte, Kathleen K.; Moos, Bernice S.

    2010-01-01

    Objective: This study focuses on the health, family, and social functioning of spouses of late-life remitted and continuing problem drinkers, and on predictors of spouses' alcohol-related functioning and depressive symptoms. Method: Three groups of spouses were compared at baseline and a 10-year follow-up: (a) spouses (n = 73) of older adults who had no drinking problems at baseline or follow-up, (b) spouses (n = 25) of older adults who had drinking problems at baseline but not follow-up, and (c) spouses (n = 69) of older adults who had drinking problems at both baseline and follow-up. At each contact point, spouses completed an inventory that assessed their alcohol-related, health, family, and social functioning. Results: At baseline, compared with spouses of problem-free individuals, spouses of older adults whose drinking problems later remitted reported more alcohol consumption, poorer health, more depressive symptoms, and less involvement in domestic tasks and social and religious activities. At the 10-year follow-up, spouses of remitted problem drinkers were comparable to spouses of problem-free individuals, but spouses of continuing problem drinkers consumed more alcohol, incurred more alcohol-related consequences, and had friends who approved more of drinking. Overall, spouses whose friends approved more of drinking and whose partners consumed more alcohol and had drinking problems were likely to consume more alcohol and to have drinking problems themselves. Conclusions: Spouses of older adults whose late-life drinking problems remit can attain normal functioning; however, spouses of older adults with continuing late-life drinking problems experience some ongoing deficits. PMID:20553658

  13. Reconciling work and family caregiving among adult-child family caregivers of older people with dementia: effects on role strain and depressive symptoms.

    Science.gov (United States)

    Wang, Yu-Nu; Shyu, Yea-Ing Lotus; Chen, Min-Chi; Yang, Pei-Shan

    2011-04-01

    This paper is a report of a study that examined the effects of work demands, including employment status, work inflexibility and difficulty reconciling work and family caregiving, on role strain and depressive symptoms of adult-child family caregivers of older people with dementia. Family caregivers also employed for pay are known to be affected by work demands, i.e. excessive workload and time pressures. However, few studies have shown how these work demands and reconciliation between work and family caregiving influence caregivers' role strain and depressive symptoms. For this cross-sectional study, secondary data were analysed for 119 adult-child family caregivers of older people with dementia in Taiwan using hierarchical multiple regression. After adjusting for demographic characteristics, resources and role demands overload, family caregivers with full-time jobs (β=0.25, Pwork and caregiving roles (β=0.36, Pworking part-time or unemployed. Family caregivers with more work inflexibility reported more depressive symptoms (β=0.29, PWork demands affected family caregivers' role strain and depressive symptoms. Working full-time and having more difficulty reconciling work and caregiving roles predicted role strain; work inflexibility predicted depressive symptoms. These results can help clinicians identify high-risk groups for role strain and depression. Nurses need to assess family caregivers for work flexibility when screening for high-risk groups and encourage them to reconcile working with family-care responsibilities to reduce role strain. © 2010 Blackwell Publishing Ltd.

  14. Current practices related to family presence during acute deterioration in adult emergency department patients.

    Science.gov (United States)

    Youngson, Megan J; Currey, Judy; Considine, Julie

    2017-11-01

    To explore the characteristics of and interactions between clinicians, patients and family members during management of the deteriorating adult patient in the emergency department. Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over the last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration. Despite the decrease in cardiac arrests, research related to family presence continues to focus on care during resuscitation rather than care during acute deterioration. Descriptive exploratory study using nonparticipatory observation. Five clinical deterioration episodes were observed within a 50-bed, urban, Australian emergency department. Field notes were taken using a semistructured tool to allow for thematic analysis. Presence, roles and engagement describe the interactions between clinicians, family members and patients while family are present during a patient's episode of deterioration. Presence was classified as no presence, physical presence and therapeutic presence. Clinicians and family members moved through primary, secondary and tertiary roles during patients' deterioration episode. Engagement was observed to be superficial or deep. There was a complex interplay between presence, roles and engagement with each influencing which form the other could take. Current practices of managing family during episodes of acute deterioration are complex and multifaceted. There is fluid interplay between presence, roles and engagement during a patient's episode of deterioration. This study will contribute to best practice, provide a strong foundation for clinician education and present opportunities for future research. © 2017 John Wiley & Sons Ltd.

  15. Family of older adults with mental disorder: perception of mental health professionals.

    Science.gov (United States)

    Saidel, Maria Giovana Borges; Campos, Claudinei José Gomes

    2017-01-01

    to understand the perceptions of healthcare professionals of the Psychosocial Care Centers regarding the family of older adults with mental disorders. study of a Qualitative Case conducted with 12 healthcare professionals from a Psychosocial Care Center, with a convenient and exhaustive sample. Conducting semi-structured interviews to collect data, which were analyzed with the Content Analysis technique. the following categories stood out: "Family exhaustion and deterioration in the perception of the healthcare professional" and "The abandonment of older adults by family members and their distancing in the perception of the healthcare professional." culpability of older adults and penalization of the family were verified by healthcare professionals. To bring awareness about the difficulties faced in the attempt to bring the family closer to the healthcare service, it is necessary to analyze the care given to the older adult and to overcome challenges in the effective construction of the bond between family, healthcare user and mental health service. compreender as percepções dos profissionais do Centro de Atenção Psicossocial acerca da família do idoso em sofrimento psíquico. estudo de Caso Qualitativo conduzido com 12 profissionais de um Centro de Atenção Psicossocial com amostra composta por intencionalidade e fechada por exaustão. Realização de entrevistas semiestruturadas para coleta de dados, analisados por meio da técnica de Análise de Conteúdo. destacaram-se as categorias "O cansaço e o desgaste familiar na percepção do profissional" e "O abandono e o afastamento do idoso pela família na percepção do profissional". verificou-se a culpabilização do idoso e a penalização da família pelos profissionais. Visando à conscientização das dificuldades em aproximar a família, é necessária a criação de espaços reflexivos sobre o cuidado a essa população, bem como a superação dos desafios na construção efetiva do vínculo entre

  16. International adoption among families in the United States: considerations of social justice.

    Science.gov (United States)

    Hollingsworth, Leslie Doty

    2003-04-01

    The practice of international adoption of children is critiqued, using Rawls' egalitarian concept of a distributive method of social justice. From this perspective, international adoption may be perceived as contradictory to principles of social justice by ignoring the social context within which it occurs. Social contexts that frequently surround international adoption are severe poverty and the disenfranchisement of the adopted child's biological family; the disenfranchisement of certain children because of their lower social status; gender oppression and discrimination against female children; risk to children's rights to the knowledge of their birth history and parentage; risk to children's rights to identification with their ethnic, cultural, and national group; and practices that may involve abduction, deceit, and trafficking in children. The article presents alternate views, including libertarian and utilitarian perspectives. Solutions from two international conventions are critiqued and implications are discussed for social work policy advocacy, practice, and research.

  17. Association of Family Composition and Metabolic Syndrome in Korean Adults Aged over 45 Years Old.

    Science.gov (United States)

    Kim, Young-Ju

    2015-12-01

    This study investigated the relationship between family composition and the prevalence of metabolic syndrome by gender in Korean adults aged 45 years and older. The sample consisted of 11,291 participants in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. We used complex sample analyses, including strata, cluster, and sample weighting, to allow generalization to the Korean population. Complex samples crosstabs and chi-square tests were conducted to compare the percentage of sociodemographic characteristics to the prevalence of metabolic syndrome and its components by gender and family composition. Next, a complex sample logistic regression was performed to examine the association between family composition and the prevalence of metabolic syndrome by gender. The percentage of adults living alone was 5.6% for men and 13.9% for women. Slightly more women (14.0%) than men (10.1%) reported living with three generations. The percentage of metabolic syndrome in Korean adults aged 45 years and older was 53.2% for men and 35.7% for women. For women, we found that living with one or three generations was significantly associated with a higher risk of metabolic syndrome, blood pressure, and triglyceride abnormality after adjusting for age, education, household income, smoking, physical activity, and body mass index, when compared to living alone. No significant relationships were found for men. A national strategy, tailored on gender and family composition, needs to be developed in order to prevent the increase of metabolic syndrome in Korean women over middle age. Copyright © 2015. Published by Elsevier B.V.

  18. Fear of water in children and adults: etiology and familial effects.

    Science.gov (United States)

    Graham, J; Gaffan, E A

    1997-02-01

    Water-fearful children (non-swimmers. 5-8 yrs and adults (non-swimmers or late learners, 23-73 yr) were compared with non-fearful controls of similar swimming ability. Parallel assessments were carried out with children and adults to investigate water-related experiences, water fear and competence in parents and siblings, and the relationship of water fear to other fear dimensions. Children were assessed behaviorally and by self and mother's report, adults by self-report. In neither children nor adults was there clear evidence that fearful and non-fearful groups differed in incidence of aversive water-related experience before fear onset. Parents usually believed that children's fear was present at first contact. In both samples, we found parent-offspring and sibling resemblances in fear. Analysis of details of children's contact with parents suggested that social learning within the family decreased water fear rather than increasing it; when both child and parent showed fear, that was as likely to reflect genetic influences as modeling. Young children's water fear forms part of a generic cluster, fear of the Unknown or Danger, while in adults it becomes independent of generic fears.

  19. Negative childhood experiences and adult love relationships: the role of internal working models of attachment.

    Science.gov (United States)

    McCarthy, Gerard; Maughan, Barbara

    2010-09-01

    This study investigated links between internal working models of attachment and the quality of adult love relationships in a high risk sample of women (n = 34), all of whom reported negative parenting in childhood. Half of the sample was identified as having a history of satisfying adult love relationships, while the remainder had experienced ongoing adult relationship problems. Measures of internal working models of attachment were made using the Adult Attachment Interview (AAI). A strong association was found between attachment classifications and the quality of adult love relationships. In addition, women with satisfying love relationships demonstrated significantly higher coherence of mind ratings than those with poor relationship histories. Insecure working models of attachment were associated with problems in adult love relationships. Although secure/autonomous attachment status was linked to optimal adult relationship outcomes, some women with a history of satisfying love relationships had insecure working models of attachment. These results suggest that the ways that adults process early experiences may influence later psychosocial functioning.

  20. Family Caregiver Factors Associated with Unmet Needs for Care of Older Adults.

    Science.gov (United States)

    Beach, Scott R; Schulz, Richard

    2017-03-01

    To examine caregiver factors associated with unmet needs for care of older adults. Population-based surveys of caregivers and older adult care recipients in the United States in 2011. 2011 National Health and Aging Trends Study and National Study of Caregiving. Family caregivers (n = 1,996) of community-dwelling older adults with disabilities (n = 1,366). Disabled care recipient reports of unmet needs for care in the past month with activities of daily living (ADLs; e.g., wet or soiled clothing), mobility (e.g., have to stay inside), or instrumental activities of daily living (IADLs; e.g., medication errors). Caregiver reported sociodemographic characteristics, caregiving intensity and tasks performed, health, and psychosocial effects. Of the care recipients, 44.3% reported at least one unmet need for care in the past month (38.2% ADL related, 14.6% IADL related). Younger caregivers, caregiving sons, caregivers not living with care recipients, and having supplemental paid caregivers were associated with more unmet needs. Caregivers with recipients reporting two or more unmet needs were more likely to spend more than 100 hours per month caregiving, help with skin care and wounds, report caregiving as emotionally and physically difficult, and report restricted participation in valued activities (all P family caregivers. Caregivers experiencing high levels of burden, stress, and negative physical and psychosocial impacts may provide substandard or poor care to older adults, which may be a risk factor for neglect. Clinicians caring for disabled older adults should assess their unmet needs and the capacity of caregivers to address them. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  1. Family health history communication networks of older adults: importance of social relationships and disease perceptions.

    Science.gov (United States)

    Ashida, Sato; Kaphingst, Kimberly A; Goodman, Melody; Schafer, Ellen J

    2013-10-01

    Older individuals play a critical role in disseminating family health history (FHH) information that can facilitate disease prevention among younger family members. This study evaluated the characteristics of older adults and their familial networks associated with two types of communication (have shared and intend to share new FHH information with family members) to inform public health efforts to facilitate FHH dissemination. Information on 970 social network members enumerated by 99 seniors (aged 57 years and older) at 3 senior centers in Memphis, Tennessee, through face-to-face interviews was analyzed. Participants shared FHH information with 27.5% of the network members; 54.7% of children and 24.4% of siblings. Two-level logistic regression models showed that participants had shared FHH with those to whom they provided emotional support (odds ratio [OR] = 1.836) and felt close to (OR = 1.757). Network-members were more likely to have received FHH from participants with a cancer diagnosis (OR = 2.617) and higher familiarity with (OR = 1.380) and importance of sharing FHH with family (OR = 1.474). Participants intended to share new FHH with those who provide tangible support to (OR = 1.804) and were very close to them (OR = 2.112). Members with whom participants intend to share new FHH were more likely to belong to the network of participants with higher perceived severity if family members encountered heart disease (OR = 1.329). Many first-degree relatives were not informed of FHH. Perceptions about FHH and disease risk as well as quality of social relationships may play roles in whether seniors communicate FHH with their families. Future studies may consider influencing these perceptions and relationships.

  2. Chemotherapy treatment decision-making experiences of older adults with cancer, their family members, oncologists and family physicians: a mixed methods study.

    Science.gov (United States)

    Puts, Martine T E; Sattar, Schroder; McWatters, Kara; Lee, Katherine; Kulik, Michael; MacDonald, Mary-Ellen; Jang, Raymond; Amir, Eitan; Krzyzanowska, Monika K; Leighl, Natasha; Fitch, Margaret; Joshua, Anthony M; Warde, Padraig; Tourangeau, Ann E; Alibhai, Shabbir M H

    2017-03-01

    Although comorbidities, frailty, and functional impairment are common in older adults (OA) with cancer, little is known about how these factors are considered during the treatment decision-making process by OAs, their families, and health care providers. Our aim was to better understand the treatment decision process from all these perspectives. A mixed methods multi-perspective longitudinal study using semi-structured interviews and surveys with 29 OAs aged ≥70 years with advanced prostate, breast, colorectal, or lung cancer, 24 of their family members,13 oncologists, and 15 family physicians was conducted. The sample was stratified on age (70-79 and 80+). All interviews were analyzed using thematic analysis. There was no difference in the treatment decision-making experience based on age. Most OAs felt that they should have the final say in the treatment decision, but strongly valued their oncologists' opinion. "Trust in my oncologist" and "chemotherapy as the last resort to prolong life" were the most important reasons to accept treatment. Families indicated a need to improve communication between them, the patient and the specialist, particularly around goals of treatment. Comorbidity and potential side-effects did not play a major role in the treatment decision-making for patients, families, or oncologists. Family physicians reported no involvement in decisions but desired to be more involved. This first study using multiple perspectives showed neither frailty nor comorbidity played a role in the treatment decision-making process. Efforts to improve communication were identified as an opportunity that may enhance quality of care. In a mixed methods study multiple perspective study with older adults with cancer, their family members, their oncologist and their family physician we explored the treatment decision making process and found that most older adults were satisfied with their decision. Comorbidity, functional status and frailty did not impact the

  3. Childhood family wealth and mental health in a national cohort of young adults.

    Science.gov (United States)

    Lê-Scherban, Félice; Brenner, Allison B; Schoeni, Robert F

    2016-12-01

    Mental health is critical to young adult health, as the onset of 75% of psychiatric disorders occurs by age 24 and psychiatric disorders early in life predict later behavioral health problems. Wealth may serve as a buffer against economic stressors. Family wealth may be particularly relevant for young adults by providing them with economic resources as they make educational decisions and move towards financial and social independence. We used prospectively collected data from 2060 young adults aged 18-27 in 2005-2011 from the Panel Study of Income Dynamics, a national cohort of US families. We examined associations between nonspecific psychological distress (measured with the K-6 scale) and childhood average household wealth during ages 0-18 years (net worth in 2010 dollars). In demographics-adjusted generalized estimating equation models, higher childhood wealth percentile was related to a lower prevalence of serious psychological distress: compared to below-median wealth, prevalence ratio (PR) = 0.56 (0.36-0.87) for 3 rd quartile and PR = 0.46 (0.29-0.73) for 4 th quartile. The associations were attenuated slightly by adjustment for parent education and more so by adjustment for childhood household income percentile. Understanding the lifelong processes through which distinct aspects of socioeconomic status affect mental health can help us identify high-risk populations and take steps to minimize future disparities in mental illness.

  4. What International Aid Organizations Can Learn from International Adult Learning: Experiences from Cambodia

    Science.gov (United States)

    Berkvens, Jan

    2012-01-01

    Purpose: Many countries receive international support to strengthen professional capacity. The effect of these professional development activities (PDAs), however, is often negligible. This article provides useful insights on how international aid organizations could improve their PDAs, by describing an intervention developed and applied in…

  5. Trajectories of Adolescent Hostile-Aggressive Behavior and Family Climate: Longitudinal Implications for Young Adult Romantic Relationship Competence

    Science.gov (United States)

    Fosco, Gregory M.; Van Ryzin, Mark J.; Xia, Mengya; Feinberg, Mark E.

    2016-01-01

    The formation and maintenance of young adult romantic relationships that are free from violence and are characterized by love, connection, and effective problem-solving have important implications for later well-being and family functioning. In this study, we examined adolescent hostile-aggressive behavior (HAB) and family relationship quality as…

  6. Physical and Psychological Health of Family Carers Co-Residing with an Adult Relative with an Intellectual Disability

    Science.gov (United States)

    Grey, Jillian M.; Totsika, Vasiliki; Hastings, Richard P.

    2018-01-01

    Background: Providing long-term care to an adult relative with intellectual disability can impact negatively on caregivers' health and well-being. Methods: Data were collected via online and postal questionnaires on 110 family carers' physical and psychological health, family stress and perceived positive gains from caring. Psychological…

  7. Impact of Family Structure on Parental Attitudes Toward the Economic Support of Adult Children Over the Transition to Adulthood

    Science.gov (United States)

    Aquilino, William S.

    2005-01-01

    This research explored the influence of family structure on midlife parents' attitudes toward the economic support of adult children and measured change in those attitudes as their oldest child moved from adolescence to young adulthood. Results suggest that family structure has long-term effects on parents' attitudes toward financial obligations…

  8. Quality of life and competitive work among adults with severe mental illness: moderating effects of family contact.

    Science.gov (United States)

    Gold, Paul B

    2013-12-01

    OBJECTIVE Competitive employment may improve life quality for adults with severe mental illness, but it is not known for whom or under what circumstances. On the basis of previous research demonstrating benefits of family contact for African-American adults with severe mental illness, it was hypothesized that frequent family contact would moderate (enhance) a positive association between competitive employment and global quality of life for a rural sample of predominantly African-American adults. METHODS In a secondary analysis of data collected from a randomized trial of supported employment, a series of nested random regression analyses was conducted to test the hypothesized moderating effect of face-to-face family contact on the association between competitive employment and global quality of life, controlling for severity of psychiatric symptoms and satisfaction with family relations. RESULTS Most of the 143 study participants spent time with a family member at least once a month (80%)-and most at least weekly (60%). Participants who held a competitive job and had face-to-face contact with family members at least weekly reported higher global quality of life than all other study participants. CONCLUSIONS In this rural sample of African-American adults with severe mental illness, competitive work was associated with higher global quality of life only for those who frequently spent time with family members. Research is needed to test the generalizability of this finding to other geographic settings and cultures, as well as the feasibility and effectiveness of formal inclusion of family members in psychosocial rehabilitation interventions.

  9. Cultural transition of international medical graduate residents into family practice in Canada.

    Science.gov (United States)

    Triscott, Jean A C; Szafran, Olga; Waugh, Earle H; Torti, Jacqueline M I; Barton, Martina

    2016-05-04

    To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths. At the same time, IMG residents appeared to experience challenges in the areas of: (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada's health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning, unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles. Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum. IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning.

  10. Combining Gender, Work, and Family Identities: The Cross-Over and Spill-Over of Gender Norms into Young Adults' Work and Family Aspirations.

    Science.gov (United States)

    Meeussen, Loes; Veldman, Jenny; Van Laar, Colette

    2016-01-01

    The current study investigates how descriptive and prescriptive gender norms that communicate work and family identities to be (in)compatible with gender identities limit or enhance young men and women's family and career aspirations. Results show that young adults ( N = 445) perceived gender norms to assign greater compatibility between female and family identities and male and work identities than vice versa, and that young men and women mirror their aspirations to this traditional division of tasks. Spill-over effects of norms across life domains and cross-over effects of norms across gender-groups indicated that young women, more than young men, aimed to 'have it all': mirroring their career ambitions to a male career model, while keeping their family aspirations high. Moreover, young women opposed traditional role divisions in the family domain by decreasing their family aspirations in face of norms of lower family involvement or higher career involvement of men. Conversely, in line with traditional gender roles, young men showed lower family aspirations in the face of strong male career norms; and showed increases in their career aspirations when perceiving women to take up more family roles. Young men's family aspirations were, however, more influenced by new norms prescribing men to invest more in their family, suggesting opportunities for change. Together, these findings show that through social norms, young adults' gender identity affects aspirations for how to manage the co-presence of their work and family identities. Altering these norms may provide leverage for change to allow both men and women to combine their multiple identities in an enriching way.

  11. EU international family law: Legal basis, sources, case law of ECJ

    Directory of Open Access Journals (Sweden)

    Bordaš Bernadet

    2012-01-01

    Full Text Available The paper offers analysis of two issues. The first is the overview of the legal basis of international family law and it's sources under the Treaty of Lisbon on the Functioning of the European Union, and the second the case law of the European Court of Justice. Since 1999, when the Treaty of Amsterdam came into force, four regulations were adopted in matters of international family law as secondary sources of EU law, and three of them came into force. National courts of Member Sates are bound to apply directly three regulations, but so far only the interpretation of Brussels II bis Regulation has reached the European Court of Justice. Some of the judgments of the Court could be of interest for Serbian private international law. The reason is in the fact that the Court gave rulings on issues and concepts which are not defined in Serbian law, so they could influence the development and definitions of the those in the course of drawing up the new Act of Private International Law in Serbia. The paper reviews the Sundelind Lopez, the Hadady, the Case A. and the Mercredi judgments.

  12. HCIV-1 and Other Tailless Icosahedral Internal Membrane-Containing Viruses of the Family Sphaerolipoviridae

    Directory of Open Access Journals (Sweden)

    Tatiana A. Demina

    2017-02-01

    Full Text Available Members of the virus family Sphaerolipoviridae include both archaeal viruses and bacteriophages that possess a tailless icosahedral capsid with an internal membrane. The genera Alpha- and Betasphaerolipovirus comprise viruses that infect halophilic euryarchaea, whereas viruses of thermophilic Thermus bacteria belong to the genus Gammasphaerolipovirus. Both sequence-based and structural clustering of the major capsid proteins and ATPases of sphaerolipoviruses yield three distinct clades corresponding to these three genera. Conserved virion architectural principles observed in sphaerolipoviruses suggest that these viruses belong to the PRD1-adenovirus structural lineage. Here we focus on archaeal alphasphaerolipoviruses and their related putative proviruses. The highest sequence similarities among alphasphaerolipoviruses are observed in the core structural elements of their virions: the two major capsid proteins, the major membrane protein, and a putative packaging ATPase. A recently described tailless icosahedral haloarchaeal virus, Haloarcula californiae icosahedral virus 1 (HCIV-1, has a double-stranded DNA genome and an internal membrane lining the capsid. HCIV-1 shares significant similarities with the other tailless icosahedral internal membrane-containing haloarchaeal viruses of the family Sphaerolipoviridae. The proposal to include a new virus species, Haloarcula virus HCIV1, into the genus Alphasphaerolipovirus was submitted to the International Committee on Taxonomy of Viruses (ICTV in 2016.

  13. Developmental and familial predictors of adult cognitive traits in the European starling

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    Nettle, Daniel; Andrews, Clare P.; Monaghan, Pat; Brilot, Ben O.; Bedford, Thomas; Gillespie, Robert; Bateson, Melissa

    2015-01-01

    In birds, there is evidence that adult cognitive traits can both run in families and be affected by early developmental influences. However, different studies use different cognitive tasks, which may not be measuring the same traits, and also focus on different developmental factors. We report results from a study in which we administered multiple cognitive tasks (autoshaping, discrimination learning, reversal learning, progressive ratio schedule, extinction learning and impulsivity) to a cohort of 34 European starlings, Sturnus vulgaris, for which several early developmental measures were available. The cohort consisted of siblings raised either apart or together, whose position in the size hierarchy of the rearing brood had been experimentally manipulated. We examined how the different cognitive measures covaried, the extent to which they ran in families, and which of the developmental factors predicted which of the cognitive outcomes. We found that discrimination and reversal learning speeds were positively correlated, as were breakpoint on the progressive ratio schedule and resistance to extinction. Otherwise, the cognitive measures were uncorrelated, suggesting that they reflected different underlying traits. All traits except discrimination and reversal learning speed ran in families to a substantial extent. Using a model selection approach, we found evidence that natal brood size and developmental telomere attrition (the extent to which the birds' erythrocyte telomeres shortened in early life, an integrative measure of developmental stress) were related to several adult cognitive measures. Results are discussed with respect to the best way of measuring avian cognitive abilities, and the utility of developmental telomere attrition as a predictor of adult outcomes. PMID:26405302

  14. Cultural Differences in Young Adults' Perceptions of the Probability of Future Family Life Events.

    Science.gov (United States)

    Speirs, Calandra; Huang, Vivian; Konnert, Candace

    2017-09-01

    Most young adults are exposed to family caregiving; however, little is known about their perceptions of their future caregiving activities such as the probability of becoming a caregiver for their parents or providing assistance in relocating to a nursing home. This study examined the perceived probability of these events among 182 young adults and the following predictors of their probability ratings: gender, ethnicity, work or volunteer experience, experiences with caregiving and nursing homes, expectations about these transitions, and filial piety. Results indicated that Asian or South Asian participants rated the probability of being a caregiver as significantly higher than Caucasian participants, and the probability of placing a parent in a nursing home as significantly lower. Filial piety was the strongest predictor of the probability of these life events, and it mediated the relationship between ethnicity and probability ratings. These findings indicate the significant role of filial piety in shaping perceptions of future life events.

  15. Familial social support predicts a reduced cortisol response to stress in sexual minority young adults.

    Science.gov (United States)

    Burton, C L; Bonanno, G A; Hatzenbuehler, M L

    2014-09-01

    Social support has been repeatedly associated with mental and physical health outcomes, with hypothalamic-pituitary-adrenocortical (HPA) axis activity posited as a potential mechanism. The influence of social bonds appears particularly important in the face of stigma-related stress; however, there is a dearth of research examining social support and HPA axis response among members of a stigmatized group. To address this gap in the literature, we tested in a sample of 70 lesbian, gay, and bisexual (LGB) young adults whether family support or peer support differentially predict cortisol reactivity in response to a laboratory stressor, the Trier Social Stress Test. While greater levels of family support were associated with reduced cortisol reactivity, neither peer support nor overall support satisfaction was associated with cortisol response. These findings suggest that the association between social support and neuroendocrine functioning differs according to the source of support among members of one stigmatized group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Health Trajectories of Family Caregivers: Associations With Care Transitions and Adult Day Service Use

    Science.gov (United States)

    Liu, Yin; Kim, Kyungmin; Zarit, Steven H.

    2017-01-01

    Objective The study examines family caregivers’ health changes over 1 year on four health dimensions and explores the association of differential health trajectories with adult day service (ADS) use and caregiving transitions. Method The participants were 153 primary caregivers of individuals with dementia (IWDs) who provided information on care situations and their own health at baseline, 6-month, and 12-month interviews. Results Caregivers showed increasing functional limitations and decreasing bodily pain over time, whereas role limitation and general health perception remained stable. Furthermore, caregivers’ trajectories of functional limitation were associated with their extent of ADS use at baseline and their relatives’ placement. Discussion Health is multidimensional; all dimensions of caregiver health do not change in a uniform manner. The findings underscore the importance of the association of caregiving transitions and caregiver health and the potential health benefits of ADS use for family caregivers. PMID:25348275

  17. Towards operationalising internal distractibility (Mind Wandering) in adults with ADHD.

    Science.gov (United States)

    Biederman, Joseph; Fitzgerald, Maura; Uchida, Mai; Spencer, Thomas J; Fried, Ronna; Wicks, Jennifer; Saunders, Alexandra; Faraone, Stephen V

    2017-12-01

    To investigate whether specific symptoms of attention deficit hyperactivity disorder (ADHD) can help identify ADHD patients with mind wandering. Subjects were adults ages 18-55 of both sexes (n=41) who completed the Mind-Wandering Questionnaire (MWQ) and the ADHD module of the Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiologic Version. We used Spearman's rank correlation and Pearson's χ2 analyses to examine associations between the ADHD module and the MWQ and receiver operator characteristic (ROC) analyses to evaluate the diagnostic efficiency of the ADHD module. Out of the three ADHD domains, the inattentive ADHD scores had the strongest association with the MWQ (total: r s=0.34, df=39, p=0.03; inattentive: r s=0.38, df=39, p=0.02; Hyperactive: r s=0.17, df=39, p=0.28). Correlation analyses between individual items on the ADHD module and the MWQ showed that two inattention items ('failure to pay attention to detail' and 'trouble following instructions') were positively associated with total scores on the MWQ (p=0.02). These two inattention items had the strongest association with the MWQ (r s=0.45, df=38, p=0.004). ROC analyses showed that the combined score of the two significant inattention items had the highest efficiency (AUC=0.71) in classifying high-level mind wanderers as defined by scores greater than the median split on the MWQ. The combined score of the two inattention items best identified high-level mind wanderers. Results suggest a way to operationalise mind wandering using the symptoms of ADHD.

  18. Care Experiences of Adults With a Dual Diagnosis and Their Family Caregivers

    Directory of Open Access Journals (Sweden)

    David B. Nicholas

    2017-07-01

    Full Text Available Individuals diagnosed with developmental disability and mental illness (a “dual diagnosis” contend with multiple challenges and system-related barriers. Using an interpretive description approach, separate qualitative interviews were conducted with adults with a dual diagnosis ( n = 7 and their caregiving parents ( n = 8 to examine care-related experiences. Results indicate that individuals with a dual diagnosis and their families experience misunderstanding and stigma. Families provide informal complex care amid insufficient and uncoordinated services but are often excluded from formal care planning. A lack of available funding and services further impedes care. While negative care experiences are reported as prevalent, participants also describe instances of beneficial care. Overall, findings indicate a lack of sufficiently targeted resources, leaving families to absorb system-related care gaps. Recommendations include person- and family-centered care, navigation support, and capacity building. Prevention and emergency and crisis care services, along with housing, vocation, and other supports, are needed. Practice and research development regarding life span needs are recommended.

  19. Childhood family wealth and mental health in a national cohort of young adults

    Directory of Open Access Journals (Sweden)

    Félice Lê-Scherban

    2016-12-01

    Full Text Available Purpose: Mental health is critical to young adult health, as the onset of 75% of psychiatric disorders occurs by age 24 and psychiatric disorders early in life predict later behavioral health problems. Wealth may serve as a buffer against economic stressors. Family wealth may be particularly relevant for young adults by providing them with economic resources as they make educational decisions and move towards financial and social independence. Methods: We used prospectively collected data from 2060 young adults aged 18–27 in 2005–2011 from the Panel Study of Income Dynamics, a national cohort of US families. We examined associations between nonspecific psychological distress (measured with the K-6 scale and childhood average household wealth during ages 0–18 years (net worth in 2010 dollars. Results: In demographics-adjusted generalized estimating equation models, higher childhood wealth percentile was related to a lower prevalence of serious psychological distress: compared to lowest-quartile wealth, prevalence ratio (PR=0.52 (0.32–0.85 for 3rd quartile and PR=0.41 (0.24–0.68 for 4th quartile. The associations were attenuated slightly by adjustment for parent education and more so by adjustment for childhood household income percentile. Conclusions: Understanding the lifelong processes through which distinct aspects of socioeconomic status affect mental health can help us identify high-risk populations and take steps to minimize future disparities in mental illness. Keywords: USA, Mental health, Health disparities, Socioeconomic status, Young adults, Life course, Wealth, Multigenerational

  20. Expression of Hepatoma-derived growth factor family members in the adult central nervous system

    Directory of Open Access Journals (Sweden)

    Abouzied Mekky M

    2006-01-01

    Full Text Available Abstract Background Hepatoma-derived growth factor (HDGF belongs to a polypeptide family containing five additional members called HDGF related proteins 1–4 (HRP-1 to -4 and Lens epithelial derived growth factor. Whereas some family members such as HDGF and HRP-2 are expressed in a wide range of tissues, the expression of others is very restricted. HRP-1 and -4 are only expressed in testis, HRP-3 only in the nervous system. Here we investigated the expression of HDGF, HRP-2 and HRP-3 in the central nervous system of adult mice on the cellular level by immunohistochemistry. In addition we performed Western blot analysis of various brain regions as well as neuronal and glial cell cultures. Results HDGF was rather evenly expressed throughout all brain regions tested with the lowest expression in the substantia nigra. HRP-2 was strongly expressed in the thalamus, prefrontal and parietal cortex, neurohypophysis, and the cerebellum, HRP-3 in the bulbus olfactorius, piriform cortex and amygdala complex. HDGF and HRP-2 were found to be expressed by neurons, astrocytes and oligodendrocytes. In contrast, strong expression of HRP-3 in the adult nervous system is restricted to neurons, except for very weak expression in oligodendrocytes in the brain stem. Although the majority of neurons are HRP-3 positive, some like cerebellar granule cells are negative. Conclusion The coexpression of HDGF and HRP-2 in glia and neurons as well as the coexpression of all three proteins in many neurons suggests different functions of members of the HDGF protein family in cells of the central nervous system that might include proliferation as well as cell survival. In addition the restricted expression of HRP-3 point to a special function of this family member for neuronal cells.

  1. Hamburg's Family Literacy project (FLY) in the context of international trends and recent evaluation findings

    Science.gov (United States)

    Rabkin, Gabriele; Geffers, Stefanie; Hanemann, Ulrike; Heckt, Meike; Pietsch, Marcus

    2018-05-01

    The authors of this article begin with an introduction to the holistic concept of family literacy and learning and its implementation in various international contexts, paying special attention to the key role played by the notions of lifelong learning and intergenerational learning. The international trends and experiences they outline inspired and underpinned the concept of a prize-winning Family Literacy project called FLY, which was piloted in 2004 in Hamburg, Germany. FLY aims to build bridges between preschools, schools and families by actively involving parents and other family members in children's literacy education. Its three main pillars are: (1) parents' participation in their children's classes; (2) special sessions for parents (without their children); and (3) joint out-of-school activities for teachers, parents and children. These three pillars help families from migrant backgrounds, in particular, to develop a better understanding of German schools and to play a more active role in school life. To illustrate how the FLY concept is integrated into everyday school life, the authors showcase one participating Hamburg school before presenting their own recent study on the impact of FLY in a group of Hamburg primary schools with several years of FLY experience. The results of the evaluation clearly indicate that the project's main objectives have been achieved: (1) parents of children in FLY schools feel more involved in their children's learning and are offered more opportunities to take part in school activities; (2) the quality of teaching in these schools has improved, with instruction developing a more skills-based focus due to markedly better classroom management und a more supportive learning environment; and (3) children in FLY schools are more likely to have opportunities to accumulate experience in out-of-school contexts and to be exposed to environments that stimulate and enhance their literacy skills in a tangible way.

  2. The Complexity of Family Reactions to Identity among Homeless and College Lesbian, Gay, Bisexual, Transgender, and Queer Young Adults.

    Science.gov (United States)

    Schmitz, Rachel M; Tyler, Kimberly A

    2018-05-01

    Familial responses to lesbian, gay, bisexual, transgender, and queer (LGBTQ) young people's identities range on a spectrum from rejection to acceptance and these reactions strongly impact family relationships and young adult well-being. Less is known, however, about how family members' reactions may differ based on young people's contexts of socioeconomic status. Through a qualitative, life course analysis of in-depth interview data from 46 LGBTQ college students and LGBTQ homeless young adults, our study highlights the diverse, contextual nuances of young people's "linked lives" within their families. We find that the context of socioeconomic status influenced how a young person managed family rejection. Conversely, processes of familial acceptance were also connected to life course transitions that worked in some cases to enhance LGBTQ young adults' family relationships. Finally, the intricacy of familial reactions to a young person's LGBTQ identity transcended socioeconomic contexts as many respondents shared similar experiences of rejection and acceptance. These findings have implications for understanding how young people manage family relationships across different contexts of socioeconomic status and how these experiences can shape their life course trajectories. Results from this study can inform LGBTQ youth service providers by tailoring intervention programs that account for contextual social diversity.

  3. Perspectives on family caregiving of people aging with intellectual disability affected by dementia: Commentary from the International Summit on Intellectual Disability and Dementia.

    Science.gov (United States)

    Jokinen, Nancy; Gomiero, Tiziano; Watchman, Karen; Janicki, Matthew P; Hogan, Mary; Larsen, Frode; Beránková, Anna; Heloísa Santos, Flávia; Service, Kathy; Crowe, Jim

    2018-01-01

    This article, an output of the 2016 International Summit on Intellectual Disability and Dementia, examines familial caregiving situations within the context of a support-staging model for adults with intellectual disability (ID) affected by dementia. Seven narratives offer context to this support-staging model to interpret situations experienced by caregivers. The multidimensional model has two fundamental aspects: identifying the role and nature of caregiving as either primary (direct) or secondary (supportive); and defining how caregiving is influenced by stage of dementia. We propose staging can affect caregiving via different expressions: (1) the "diagnostic phase," (2) the "explorative phase," (3) the "adaptive phase," and (4) the "closure phase." The international narratives illustrate direct and indirect caregiving with commonality being extent of caregiver involvement and attention to the needs of an adult with ID. We conclude that the model is the first to empirically formalize the variability of caregiving within families of people with ID that is distinct from other caregiving groups, and that many of these caregivers have idiosyncratic needs. A support-staging model that recognizes the changing roles and demands of carers of people with ID and dementia can be useful in constructing research, defining family-based support services, and setting public policy.

  4. Developmental evaluation of family functioning deficits in youths and young adults with childhood-onset bipolar disorder.

    Science.gov (United States)

    MacPherson, Heather A; Ruggieri, Amanda L; Christensen, Rachel E; Schettini, Elana; Kim, Kerri L; Thomas, Sarah A; Dickstein, Daniel P

    2018-08-01

    Childhood-onset bipolar disorder (BD) is a serious condition that affects the patient and family. While research has documented familial dysfunction in individuals with BD, no studies have compared developmental differences in family functioning in youths with BD vs. adults with prospectively verified childhood-onset BD. The Family Assessment Device (FAD) was used to examine family functioning in participants with childhood-onset BD (n = 116) vs. healthy controls (HCs) (n = 108), ages 7-30 years, using multivariate analysis of covariance and multiple linear regression. Participants with BD had significantly worse family functioning in all domains (problem solving, communication, roles, affective responsiveness, affective involvement, behavior control, general functioning) compared to HCs, regardless of age, IQ, and socioeconomic status. Post-hoc analyses suggested no influence for mood state, global functioning, comorbidity, and most medications, despite youths with BD presenting with greater severity in these areas than adults. Post-hoc tests eliminating participants taking lithium (n = 17) showed a significant diagnosis-by-age interaction: youths with BD had worse family problem solving and communication relative to HCs. Limitations include the cross-sectional design, clinical differences in youths vs. adults with BD, ambiguity in FAD instructions, participant-only report of family functioning, and lack of data on psychosocial treatments. Familial dysfunction is common in childhood-onset BD and endures into adulthood. Early identification and treatment of both individual and family impairments is crucial. Further investigation into multi-level, family-based mechanisms underlying childhood-onset BD may clarify the role family factors play in the disorder, and offer avenues for the development of novel, family-focused therapeutic strategies. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Decline in the Quality of Family Relationships Predicts Escalation in Children’s Internalizing Symptoms from Middle to Late Childhood

    Science.gov (United States)

    Kochanska, Grazyna

    2015-01-01

    An integration of family systems perspectives with developmental psychopathology provides a framework for examining the complex interplay between family processes and developmental trajectories of child psychopathology over time. In a community sample of 98 families, we investigated the evolution of family relationships, across multiple subsystems of the family (i.e., interparental, mother-child, father-child), and the impact of these changing family dynamics on developmental trajectories of child internalizing symptoms over 6 years, from preschool age to pre-adolescence. Parent–child relationship quality was observed during lengthy sessions, consisting of multiple naturalistic, carefully scripted contexts. Each parent completed reports about interparental relationship satisfaction and child internalizing symptoms. To the extent that mothers experienced a steeper decline in interparental relationship satisfaction over time, children developed internalizing symptoms at a faster rate. Further, symptoms escalated at a faster rate to the extent that negative mother-child relationship quality increased (more negative affect expressed by both mother and child, greater maternal power assertion) and positive mother-child relationship quality decreased (less positive affect expressed by both mother and child, less warmth and positive reciprocity). Time-lagged growth curve analyses established temporal precedence such that decline in family relationships preceded escalation in child internalizing symptoms. Results suggest that family dysfunction, across multiple subsystems, represents a driving force in the progression of child internalizing symptoms. PMID:25790794

  6. Linking Extreme Precocity and Adult Eminence: A Study of Eight Prodigies at International Chess

    Science.gov (United States)

    Howard, Robert W.

    2008-01-01

    Do prodigies have extraordinary innate talent or do they just start very early and get much practice? Why do relatively few become eminent as adults? Is it because early and later success often need somewhat different abilities and gatekeepers rule? International chess is a good test domain for both issues because it has objective longitudinal…

  7. Examining English Language Learning Motivation of Adult International Learners Studying Abroad in the US

    Science.gov (United States)

    Weger, Heather D.

    2013-01-01

    The present study reports on the motivations of adult, international learners of English, studying English 20 hours a week in a US-based Intensive English Program (IEP). Though often used as participants in language acquisition studies, there are few studies of these learners' motivational profiles. In the current study, a questionnaire designed…

  8. Specific needs of families of young adults with profound intellectual disability during and after transition to adulthood: What are we missing?

    Science.gov (United States)

    Gauthier-Boudreault, Camille; Gallagher, Frances; Couture, Mélanie

    2017-07-01

    At the age of 21, the trajectory of services offered to youth with profound intellectual disability (ID) change significantly since access to specialised services is more limited. Despite the desire of parents to avoid any impact on their child, several factors can influence the course of this transition. However, there is little research on facilitators and obstacles to the transition to adulthood, and impacts on people with a profound ID. It is therefore difficult to provide solutions that meet their specific needs. The study aimed to document the needs of parents and young adults with profound ID during and after the transition to adulthood by exploring their transitioning experience and factors that influenced it. Using a descriptive qualitative design, two individual semi-structured interviews were conducted with fourteen (14) parents of young adults aged between 18 and 26 with a profound ID. At this point, many material, informative, cognitive and emotional needs of young adults and their parents are not met. Obstacles, mainly organisational, persist and result in a particularly difficult transition to adulthood experience. By knowing the specific needs of these families, it is possible to develop and implement solutions tailored to their reality. WHAT THE PAPERS ADDS?: The transition to adulthood is a critical period for families with young adults with an intellectual disability (ID), a reality observed internationally. Current literature on all levels of ID suggests some barriers to transition that lead to negative impacts on both parents and young adults with ID. However, presently, very little research exists on the reality of families of young adults with profound ID and factors influencing transition to adult life. Most of studies target people with mild to moderate ID. Considering the significant disabilities of people with profound ID, it is possible to imagine that their experience of transition will be even more difficult and they will present

  9. Interventions for adult family carers of people who have had a stroke: a systematic review.

    Science.gov (United States)

    Brereton, Louise; Carroll, Christopher; Barnston, Sue

    2007-10-01

    A systematic review of the effectiveness of interventions for adult family carers of people with stroke, and an exploratory examination of the relationship between the conceptual basis of these interventions and their effectiveness. Seventeen electronic databases and grey literature sources were searched, including ASSIA, BNI, Cochrane Library, CINAHL, EMBASE, MEDLINE, PsycINFO, Social Science Citation Index and the Science Citation Index, HMIC and the National Research Register. Authors of unpublished material were contacted for data and additional publications. Reference and citation tracking was performed on included publications. randomized controlled trials of interventions aimed primarily at adult family carers of people post stroke; carers were the primary sample; primary outcomes reported were for carers. Two independent reviewers screened titles and abstracts to identify publications and extract data. Quality assessment was performed to weight study findings. Eight papers were found reporting on six complex, generally heterogeneous, interventions: caregiver training; education and counselling; social problem-solving partnerships, delivered principally by telephone; a psycho-educational telephone support group; a nurse-led support and education programme; and a support programme, delivered either to groups in hospital or individuals during home visits. Half of the interventions were based on stress-coping theories; the remainder did not identify a conceptual basis for the intervention. Some benefits were reported for all interventions, although trials were generally of low quality, preventing firm conclusions being drawn. The presence of a conceptual basis for interventions does not appear to influence effectiveness.

  10. The role of patients' families in treatment decision-making among adult cancer patients in the Sultanate of Oman.

    Science.gov (United States)

    Al-Bahri, A; Al-Moundhri, M; Al-Mandhari, Z; Al-Azri, M

    2018-04-17

    There are limited numbers of studies available in Middle Eastern Arabic countries regarding participation of family ‎members in cancer treatment decision-making (TDM). The aim of this study was to evaluate the role of family members' ‎in TDM among ‎adult Omani cancer ‎patients. A cross-sectional study was conducted in two main teaching hospitals. All adult Omani patients who were diagnosed with cancer and their nominated family members were invited to ‎participate. A tool developed by Cancer Care Outcomes Research and ‎Surveillance Consortium was used to identify the level of family involvement in TDM. A weighted kappa (k) was significant (p time of diagnosis ‎(OR = 3.10; 95% CI: 1.37-7.03). Oncologists in Oman should be aware of the strong family involvement in TDM to allow a successful cancer treatment. © 2018 John Wiley & Sons Ltd.

  11. Vulnerability within families headed by teen and young adult mothers investigated by child welfare services in Canada.

    Science.gov (United States)

    Hovdestad, W; Shields, M; Williams, G; Tonmyr, L

    2015-01-01

    Young mothers' families are at increased risk of child maltreatment and other poor health and social outcomes. Chi-square analyses of pooled child welfare services data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003; CIS-2008) were used to compare 284 teen mothers (18 years or younger) and 800 young mothers (19-21 years) and their families with 5752 families where the mother was 22 years or older. Twenty-six percent of young mothers were 18 years or younger. Most (68% of teen-mother families and 57% of families with a young adult mother) received social assistance as their main source of income compared with 36% of families with a mother aged 22 years or older. Teen and young adult mothers were more likely than those aged 22 or older to have childhood histories of out-of-home care (31% and 23% vs. 10%) and were more likely to have risk factors such as alcohol abuse (25% and 23% vs. 18%) and few social supports (46% and 41% vs. 37%). Secondary caregivers in families with young mothers also had more risk factors. Teen and young adult mother families were more likely to have their child placed out-of-home during the investigation (29% and 27% vs. 17%). All were equally likely to be victims of domestic violence and to have mental health issues. Within this sample of high-risk families, young mothers' families were more at risk than comparison families. Mothers' youth may be a useful criterion to identify families for targeted interventions.

  12. Vulnerability within families headed by teen and young adult mothers investigated by child welfare services in Canada

    Directory of Open Access Journals (Sweden)

    W. Hovdestad

    2015-01-01

    Full Text Available Introduction: Young mothers' families are at increased risk of child maltreatment and other poor health and social outcomes. Methods: Chi-square analyses of pooled child welfare services data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003; CIS-2008 were used to compare 284 teen mothers (18 years or younger and 800 young mothers (19-21 years and their families with 5752 families where the mother was 22 years or older. Results: Twenty-six percent of young mothers were 18 years or younger. Most (68% of teen-mother families and 57% of families with a young adult mother received social assistance as their main source of income compared with 36% of families with a mother aged 22 years or older. Teen and young adult mothers were more likely than those aged 22 or older to have childhood histories of out-of-home care (31% and 23% vs. 10% and were more likely to have risk factors such as alcohol abuse (25% and 23% vs. 18% and few social supports (46% and 41% vs. 37%. Secondary caregivers in families with young mothers also had more risk factors. Teen and young adult mother families were more likely to have their child placed out-of-home during the investigation (29% and 27% vs. 17%. All were equally likely to be victims of domestic violence and to have mental health issues. Conclusion: Within this sample of high-risk families, young mothers' families were more at risk than comparison families. Mothers' youth may be a useful criterion to identify families for targeted interventions.

  13. International issues: Obtaining an adult neurology residency position in the United States: an overview.

    Science.gov (United States)

    Jordan, Justin T; Sellner, Johann; Struhal, Walter; Schneider, Logan; Mayans, David

    2014-04-08

    Around the world, there are marked differences in neurology training, including training duration and degree of specialization. In the United States, adult neurology residency is composed of 1 year of internal medicine training (preliminary year) and 3 years of neurology-specific training. Child neurology, which is not the focus of this article, is 2 years of pediatrics and 3 years of neurology training. The route to adult neurology residency training in the United States is standardized and is similar to most other US specialties. Whereas US medical graduates often receive stepwise guidance from their medical school regarding application for residency training, international graduates often enter this complex process with little or no such assistance. Despite this discrepancy, about 10%-15% of residency positions in the United States are filled by international medical graduates.(1,2) In adult neurology specifically, 35% of matched positions were filled by international graduates in 2013, 75% of whom were not US citizens.(1) In an effort to provide a preliminary understanding of the application process and related terminology (table 1) and thereby encourage international residency applicants, we describe the steps necessary to apply for neurology residency in the United States.

  14. A mixed methods exploration of family involvement in medical care for older adults with serious mental illness.

    Science.gov (United States)

    Aschbrenner, Kelly A; Pepin, Renee; Mueser, Kim T; Naslund, John A; Rolin, Stephanie A; Faber, Marjan J; Bartels, Stephen J

    2014-01-01

    Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received little attention. This study explored family involvement in medical care for older adults with SMI. This mixed methods study involved analysis of quantitative data collected from older adults with SMI and cardiovascular risk (n = 28) participating in a pilot study of an intervention designed to improve patient-centered primary care augmented by qualitative interviews with their relatives (n = 13) to explore family involvement in medical care. Approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medical visits, and most did not perceive a need to be involved during routine care. Family members identified obesity as their relative's primary health concern and many wanted guidance from providers on effective strategies for supporting weight loss. Although many family members did not perceive a need to be involved in their relative's routine medical visits, they expressed interest in talking with providers about how to help their relative change unhealthy behaviors. Educating patients, families, and providers about the potential benefits of family involvement in medical care, including routine medical visits for persons with SMI and cardiovascular health risk may promote patient- and family-centered collaboration in this high-risk population.

  15. Impaired Fasting Glucose in Omani Adults with no Family History of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Sawsan Al-Sinani

    2014-05-01

    Full Text Available Objectives: The aim of this study was to estimate the prevalence of impaired fasting glucose (IFG among Omani adults with no family history (FH of diabetes and to investigate the factors behind the risk of developing type 2 diabetes (T2D, while excluding a FH of diabetes. Methods: A total of 1,182 Omani adults, aged ≥40 years, visited the Family Medicine & Community Health Clinic at Sultan Qaboos University Hospital, Oman, on days other than the Diabetes Clinic days, from July 2010 to July 2011. The subjects were interviewed and asked if they had T2D or a FH of T2D. Results: Only 191 (16% reported no personal history of T2D or FH of the disease. Of these, anthropometric and biochemical data was complete in 159 subjects. Of these a total of 42 (26% had IFG according to the American Diabetes Association criteria. Body mass index, fasting insulin, haemoglobin A1C and blood pressure (BP, were significantly higher among individuals with IFG (P <0.01, P <0.05, P <0.01 and P <0.01, respectively. In addition, fasting insulin, BP and serum lipid profile were correlated with obesity indices (P <0.05. Obesity indices were strongly associated with the risk of IFG among Omanis, with waist circumference being the strongest predictor. Conclusion: Despite claiming no FH of diabetes, a large number of Omani adults in this study had a high risk of developing diabetes. This is possibly due to environmental factors and endogamy. The high prevalence of obesity combined with genetically susceptible individuals is a warning that diabetes could be a future epidemic in Oman.

  16. Effect of Perceived Stigmatisation on the Quality of Life among Ageing Female Family Carers: A Comparison of Carers of Adults with Intellectual Disability and Carers of Adults with Mental Illness

    Science.gov (United States)

    Chou, Y. C.; Pu, C. Y.; Lee, Y. C.; Lin, L. C.; Kroger, T.

    2009-01-01

    Background: Little account has been taken of quality of life (QoL) among family carers of adults with an intellectual disability (ID) and family carers of adults with a mental illness (MI), particularly the female ageing carers' perceived stigma. We explore whether there are differences in the significant predictors of female ageing family carers'…

  17. Cortisol Awakening Response, Internalizing Symptoms, and Life Satisfaction in Emerging Adults

    Directory of Open Access Journals (Sweden)

    Li Shen Chong

    2017-11-01

    Full Text Available The cortisol awakening response (CAR has been associated with depression and a broader range of internalizing problems. Emerging adulthood is characterized by numerous stressful transitional life events. Furthermore, the functioning of the neurobiological stress system changes across development. These considerations underscore the importance of evaluating the physiological stress system in emerging adults in identifying the extent to which cortisol levels vary with risk and protective factors for mental health. The present study evaluated the association between internalizing symptoms and perceived life satisfaction with CAR in 32 young adults. Three saliva samples were collected to measure cortisol levels upon awakening and participants completed the Depression Anxiety Stress Scale (DASS and Satisfaction with Life Scale (SWLS. Results show a significant positive correlation between area under the curve for CAR with internalizing symptoms (DASS total and the DASS-depression subscale, but not with life satisfaction. Study limitations, implications, and future directions for these finding were discussed.

  18. The Interactive Effects of Stressful Family Life Events and Cortisol Reactivity on Adolescent Externalizing and Internalizing Behaviors

    Science.gov (United States)

    Steeger, Christine M.; Cook, Emily C.; Connell, Christian M.

    2016-01-01

    This study investigated the associations between stressful family life events and adolescent externalizing and internalizing behaviors, and the interactive effects of family life events and cortisol reactivity on problem behaviors. In a sample of 100 mothers and their adolescents (M age = 15.09; SD age = 0.98; 68% girls), adolescent cortisol reactivity was measured in response to a mother-adolescent conflict interaction task designed to elicit a stress response. Mothers reported on measures of family life events and adolescent problem behaviors. Results indicated that a heightened adolescent cortisol response moderated the relations between stressful family life events and both externalizing and internalizing behaviors. Results support context-dependent theoretical models, suggesting that for adolescents with higher cortisol reactivity (compared to those with lower cortisol reactivity), higher levels of stressful family life events were associated with greater problem behaviors, whereas lower levels of stressful family life events were related to fewer problem behaviors. PMID:26961703

  19. Teaching corner: child family health international : the ethics of asset-based global health education programs.

    Science.gov (United States)

    Evert, Jessica

    2015-03-01

    Child Family Health International (CFHI) is a U.S.-based nonprofit, nongovernmental organization (NGO) that has more than 25 global health education programs in seven countries annually serving more than 600 interprofessional undergraduate, graduate, and postgraduate participants in programs geared toward individual students and university partners. Recognized by Special Consultative Status with the United Nations Economic and Social Council (ECOSOC), CFHI utilizes an asset-based community engagement model to ensure that CFHI's programs challenge, rather than reinforce, historical power imbalances between the "Global North" and "Global South." CFHI's programs are predicated on ethical principles including reciprocity, sustainability, humility, transparency, nonmaleficence, respect for persons, and social justice.

  20. The Vocational Turn in Adult Literacy Education and the Impact of the International Adult Literacy Survey

    Science.gov (United States)

    Druine, Nathalie; Wildemeersch, Danny

    2000-09-01

    The authors critically examine some of the underlying epistemological and theoretical assumptions of the IALS. In doing so, they distinguish among two basic orientations towards literacy. First, the standard approach (of which IALS is an example) subscribes to the possibility of measuring literacy as abstract, cognitive skills, and endorses the claim that there is an important relationship between literacy skills and economic success in the so-called 'knowledge society.' The second, called a socio-cultural approach, insists on the contextual and power-related character of people's literacy practices. The authors further illustrate that the assumptions of the IALS are rooted in a neo-liberal ideology that forces all members of society to adjust to the exigencies of the globalised economy. In the current, contingent conditions of the risk society, however, it does not seem very wise to limit the learning of adults to enhancing labour-market competencies. Adult education should relate to the concrete literacy practices people already have in their lives. It should make its learners co-responsible actors of their own learning process and participants in a democratic debate on defining the kind of society people want to build.

  1. Comparison of internal radiation doses estimated by MIRD and voxel techniques for a ''family'' of phantoms

    International Nuclear Information System (INIS)

    Smith, T.

    2000-01-01

    The aim of this study was to use a new system of realistic voxel phantoms, based on computed tomography scanning of humans, to assess its ability to specify the internal dosimetry of selected human examples in comparison with the well-established MIRD system of mathematical anthropomorphic phantoms. Differences in specific absorbed fractions between the two systems were inferred by using organ dose estimates as the end point for comparison. A ''family'' of voxel phantoms, comprising an 8-week-old baby, a 7-year-old child and a 38-year-old adult, was used and a close match to these was made by interpolating between organ doses estimated for pairs of the series of six MIRD phantoms. Using both systems, doses were calculated for up to 22 organs for four radiopharmaceuticals with widely differing biodistribution and emission characteristics (technetium-99m pertechnetate, administered without thyroid blocking; iodine-123 iodide; indium-111 antimyosin; oxygen-15 water). Organ dose estimates under the MIRD system were derived using the software MIRDOSE 3, which incorporates specific absorbed fraction (SAF) values for the MIRD phantom series. The voxel system uses software based on the same dose calculation formula in conjunction with SAF values determined by Monte Carlo analysis at the GSF of the three voxel phantoms. Effective doses were also compared. Substantial differences in organ weights were observed between the two systems, 18% differing by more than a factor of 2. Out of a total of 238 organ dose comparisons, 5% differed by more than a factor of 2 between the systems; these included some doses to walls of the GI tract, a significant result in relation to their high tissue weighting factors. Some of the largest differences in dose were associated with organs of lower significance in terms of radiosensitivity (e.g. thymus). In this small series, voxel organ doses tended to exceed MIRD values, on average, and a 10% difference was significant when all 238 organ doses

  2. Internal consistency of the CHAMPS physical activity questionnaire for Spanish speaking older adults.

    Science.gov (United States)

    Rosario, Martín G; Vázquez, Jenniffer M; Cruz, Wanda I; Ortiz, Alexis

    2008-09-01

    The Community Healthy Activities Model Program for Seniors (CHAMPS) is a physical activity monitoring questionnaire for people between 65 to 90 years old. This questionnaire has been previously translated to Spanish to be used in the Latin American population. To adapt the Spanish version of the CHAMPS questionnaire to Puerto Rico and assess its internal consistency. An external review committee adapted the existent Spanish version of the CHAMPS to be used in the Puerto Rican population. Three older adults participated in a second phase with the purpose of training the research team. After the second phase, 35 older adults participated in a third content adaptation phase. During the third phase, the preliminary Spanish version for Puerto Rico of the CHAMPS was given to the 35 participants to assess for clarity, vocabulary and understandability. Interviews to each participant in the third phase were carried out to obtain feedback and create a final Spanish version of the CHAMPS for Puerto Rico. After analyses of this phase, the external review committee prepared a final Spanish version of the CHAMPS for Puerto Rico. The final version was administered to 15 older adults (76 +/- 6.5 years) to assess the internal consistency by using Cronbach's Alpha analysis. The questionnaire showed a strong internal consistency of 0.76. The total time to answer the questionnaire was 17.4 minutes. The Spanish version of the CHAMPS questionnaire for Puerto Rico suggested being an easy to administer and consistent measurement tool to assess physical activity in older adults.

  3. Family and Other Unpaid Caregivers and Older Adults with and without Dementia and Disability.

    Science.gov (United States)

    Riffin, Catherine; Van Ness, Peter H; Wolff, Jennifer L; Fried, Terri

    2017-08-01

    To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia and with or without substantial disability; to describe the characteristics of caregivers and care recipients in these groups; to characterize the health-related tasks that caregivers provide; and to estimate associations between the numbers of tasks and caregiver burden. Nationally representative surveys of caregivers and older adults in the United States. 2011 National Health and Aging Trends Study and National Study of Caregiving. Community-dwelling older adults and their family caregivers, who were selected on the basis of having assisted with mobility, self-care, household activities, transportation, or medical tasks. Caregiver burden (emotional, physical, financial difficulties) and restrictions on social participation. Although much larger proportions of older adults with dementia and disability (98.4%, n = 1.0 million) and dementia but not disability (95.5%, n = 1.3 million) received caregiving assistance, the largest absolute number of individuals receiving assistance were older adults without dementia or disability (4.0 million). Within each caregiver group, caregivers provided assistance with at least one task across domains of activity of daily living and instrumental activity of daily living-related assistance (>98%), health systems logistics (>70%), and health management (>50%). There was a significant linear association between number of tasks provided and risk of burden in virtually all caregiver groups and domains of assistance. Caregivers of care recipients without dementia or disability accounted for the largest absolute number of helpers. These caregivers, similar to caregivers of care recipients with dementia or disability, delivered a broad spectrum of health-related tasks and experienced caregiver burden and restrictions on social participation. Findings support the need for interventions that address the needs of caregivers

  4. Constructive staff-family relationships in the care of older adults in the institutional setting: A systematic review.

    Science.gov (United States)

    Haesler, Emily; Bauer, Michael; Nay, Rhonda

    2004-01-01

    Modern health care philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's wellbeing. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family imvolvement in the health care of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the health care environment to benefit from the involvement of their family members, health care professionals need an understanding of the issues surrounding family presence in the health care environement and the strategies to best support it. The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff-family relationships in the care of older adults in the health care setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff-family relationships. A literature search was performed using the following databases for the years 1990-2005: Ageline, APAIS Health, Australian Family & Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO, and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference

  5. Peer education as a strategy for reducing internalized stigma among depressed older adults.

    Science.gov (United States)

    Conner, Kyaien O; McKinnon, Symone A; Ward, Christine J; Reynolds, Charles F; Brown, Charlotte

    2015-06-01

    This article examines the mechanisms through which peer educator (PE) intervention targets and reduces internalized stigma. There is substantial evidence that internalized stigma negatively impacts the lives of those suffering with mental health concerns, and has been identified as 1 of the most significant barriers to seeking professional mental health services. There has been a push toward identifying interventions and programs that effectively reduce and mitigate the impact of internalized stigma. Research suggests that contact with other individuals who share a stigmatized condition may be a promising approach to targeting and reducing internalized stigma. However, there is a dearth of research that has identified the mechanism through which this contact impacts internalized stigma. Study participants (n = 19) completed a 3-month PE intervention. Each participant was matched with an older adult with a history of depression currently in recovery who provided psychoeducation, social support, and motivational interviewing. Participants completed a demographic questionnaire, public stigma (PDD), and internalized stigma (Internalized Stigma of Mental Illness, ISMI) scales pre- and post-PE intervention. They further participated in a brief semistructured qualitative interview to attain in-depth information about their perceptions of stigma and of working with a PE. Overall, internalized stigma scores were significantly reduced after participating in the PE intervention. In addition, participants identified 4 mechanisms through which contact with their PE impacted their stigmatized beliefs: age related concerns, shared understanding, improved mental health literacy, and mutual support. This study suggests that PE is a potentially valuable approach toward reducing internalized stigma among older adults with depression. (c) 2015 APA, all rights reserved).

  6. Associations between Discussions of Racial and Ethnic Differences in Internationally Adoptive Families and Delinquent Behavior among Korean Adopted Adolescents.

    Science.gov (United States)

    Anderson, Kayla N; Lee, Richard M; Rueter, Martha A; Kim, Oh Myo

    2015-04-01

    Internationally adopted adolescents may have more delinquent behavior than non-adopted adolescents. One explanation is these adolescents experience discrimination and loss of culture, and adoptive parents are not adequately addressing these experiences. However, studies have not examined the effects of family discussions of racial and ethnic differences within adoptive families on adopted adolescents' delinquent behavior. To test this relationship, this study utilized data from 111 U.S. internationally adoptive families with 185 South Korean adopted adolescents (55% female, M age = 17.75). During an observational assessment, families discussed the importance of their racial and ethnic differences, and adolescents completed a delinquent behavior questionnaire. Analysis of covariance showed differences in adolescent delinquent behavior across three ways adoptive families discussed racial and ethnic differences; adolescents whose families acknowledged differences had the fewest mean delinquent behaviors. There were no significant differences in delinquent behavior between adolescents whose families acknowledged or rejected the importance of racial and ethnic differences. However, adopted adolescents whose families held discrepant views of differences had significantly more problem behavior than adolescents whose families either acknowledged or rejected the importance of racial and ethnic differences. Clinicians, adoption professionals, and other parenting specialists should focus on building cohesive family identities about racial and ethnic differences, as discrepant views of differences are associated with the most adoptee delinquent behavior.

  7. Relationship between cancer-related traumatic stress and family milestone achievement in adolescent and young adult survivors of childhood cancer.

    Science.gov (United States)

    Tillery, Rachel; Beal, Sarah J; Thompson, Aimee N; Pai, Ahna L H

    2018-06-01

    Late physical and emotional effects of cancer treatment pose a burden for adolescent and young adult survivors of childhood cancer, including family milestone achievement. This brief report examined links between ongoing cancer-related post-traumatic stress symptoms (CR-PTSS) and family milestone achievement. Survivors (n = 51; M age  = 24.73, SD = 8.20) completed CR-PTSS and family formation questionnaires. Descriptive statistics, univariate parameter-constraints, and correlation analyses examined relations among study variables. Ongoing intrusive thoughts and hyperarousal were negatively linked to family identity development and family achievement. Findings from the present study provide support that ongoing CR-PTSS may be a barrier to family formation. © 2018 Wiley Periodicals, Inc.

  8. Family Enterprises in Polish Consumers' Mindset in the Light of International Tendencies

    Directory of Open Access Journals (Sweden)

    Joanna Bednarz

    2017-07-01

    Full Text Available Aim/purpose - The main aim of the paper is to fill in the gap in the existing literature as well as to propose a set of specific family enterprises' (FE attributes concerning certain socioeconomic conditions in Poland. The objectives of the article are interrelated with two theses. H1 assumes that in current literature there is a little attention paid to the demand side of the market, particularly to the individual consumers (including young buyers and their attitudes toward FEs. H2 indicates that the perception of Polish FEs changes considerably reflecting the international trends. Design/methodology/approach - The authors studied a consolidated profound review of recent international and Polish publications on FEs. The expert interviews and in-depth individual interviews were conducted. Both empirical studies brought a preliminary insight into overall consumer perception of the FEs in Poland. Findings - For several years Polish buyers have been dynamically changing their mindset, breaking the stereotype of FEs' owners. Nowadays, tradition and quality are two attributes which are associated closely with Polish FEs. Customers indicate that FEs are trustworthy, responsible, solid and dependable. They also highlight the ethnocentric attitude toward these companies - Polishness. All these attributes are evidently appreciated. FEs are correlated with traditional industries and products, especially with groceries, cosmetics, clothes, shoes, jewelry, furniture, windows and doors. Research implications/limitations - The identity of FEs is not always communicated properly. Consumers often cannot ascertain a provenance of their offer as many FEs do not emphasize their family identity. Additionally, on the Polish market, consumers are occasionally misled considering the family ownership of a business. Originality/value/contribution - The studies indicate a set of attributes typical of Polish FEs underpinning their strong identity which should be

  9. Perceptions of International Female Students toward E-Learning in Resolving High Education and Family Role Strain

    Science.gov (United States)

    Kibelloh, Mboni; Bao, Yukun

    2014-01-01

    It is a common phenomenon for many mature female international students enrolled in high education overseas to experience strain from managing conflicting roles of student and family, and difficulties of cross-cultural adjustment. The purpose of this study is to examine perceptions and behavioral intentions of international female students toward…

  10. End-of-Year 2010-11 Progress Report to the Legislature: Implementation and Impact of the Workforce Investment Act, Title II Adult Education and Family Literacy Act

    Science.gov (United States)

    CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2012

    2012-01-01

    The Federal Workforce Investment Act (WIA), Title II: Adult Education and Family Literacy Act (AEFLA) provides funding for states and territories to provide instruction in English as a Second Language (ESL), Adult Basic Education (ABE), and Adult Secondary Education (ASE) to adults in need of these literacy services. California State Budget Act…

  11. Reducing youth internalizing symptoms: Effects of a family-based preventive intervention on parental guilt induction and youth cognitive style

    Science.gov (United States)

    McKEE, LAURA G.; PARENT, JUSTIN; FOREHAND, REX; RAKOW, AARON; WATSON, KELLY H.; DUNBAR, JENNIFER P.; REISING, MICHELLE M.; HARDCASTLE, EMILY; COMPAS, BRUCE E.

    2014-01-01

    This study utilized structural equation modeling to examine the associations among parental guilt induction (a form of psychological control), youth cognitive style, and youth internalizing symptoms, with parents and youth participating in a randomized controlled trial of a family-based group cognitive–behavioral preventive intervention targeting families with a history of caregiver depression. The authors present separate models utilizing parent report and youth report of internalizing symptoms. Findings suggest that families in the active condition (family-based group cognitive–behavioral group) relative to the comparison condition showed a significant decline in parent use of guilt induction at the conclusion of the intervention (6 months postbaseline). Furthermore, reductions in parental guilt induction at 6 months were associated with significantly lower levels of youth negative cognitive style at 12 months. Finally, reductions in parental use of guilt induction were associated with lower youth internalizing symptoms 1 year following the conclusion of the intervention (18 months postbaseline). PMID:24438999

  12. Research Notes ~ Virtual Community for Adults with Developmental Disabilities and their Families

    Directory of Open Access Journals (Sweden)

    Susan D. Moisey

    2001-07-01

    Full Text Available Adults with developmental disabilities in Northeast Alberta, Canada, face numerous barriers to learning opportunities within their immediate and extended communities. The disability itself, as well as geographic distance and the circumstances in which individuals live, may hamper their access to information, interfere with their ability to communicate, and reduce their ability to achieve the quality of life they desire. There are few opportunities for individuals to meet, to get to know each other, and to share their experiences and learn from each other. Family members and guardians face similar barriers, such as lack of access to information, few networking opportunities, and limited means of providing input into decisions about service needs and policy making.

  13. Meet the parents? Family size and the geographic proximity between adult children and older mothers in Sweden.

    Science.gov (United States)

    Holmlund, Helena; Rainer, Helmut; Siedler, Thomas

    2013-06-01

    The aim of this study is to estimate the causal effect of family size on the proximity between older mothers and adult children by using a large administrative data set from Sweden. Our main results show that adult children in Sweden are not constrained by sibship size in choosing where to live: for families with more than one child, sibship size does not affect child-mother proximity. For aging parents, however, having fewer children reduces the probability of having at least one child living nearby, which is likely to have consequences for the intensity of intergenerational contact and eldercare.

  14. Effects on resilience of women family caregivers of adults with serious mental illness: the role of positive cognitions.

    Science.gov (United States)

    Zauszniewski, Jaclene A; Bekhet, Abir K; Suresky, M Jane

    2009-12-01

    This study examined the effects of risk and protective factors on resilience in 60 women family members of adults with serious mental illness. Both the risk factors constituting caregiver burden (strain, stigma, client dependence, and family disruption) and protective factors, including eight positive cognitions were found to predict two indicators of resilience: resourcefulness and sense of coherence. The effects of caregiver burden on resourcefulness and sense of coherence were mediated by positive cognitions, lending support to resilience theory and suggesting the need to develop interventions to encourage positive thinking among women caregivers of adults with mental illness.

  15. Stressors among Hispanic adults from immigrant families in the United States: Familismo as a context for ambivalence.

    Science.gov (United States)

    Rojas, Sasha M; Grzywacz, Joseph G; Zapata Roblyer, Martha I; Crain, Rebecca; Cervantes, Richard C

    2016-07-01

    Ongoing exposure to social stressors is widely believed to undermine the health of Hispanic immigrant families. The current work aims to explore and interpret expressions of familismo as a framework through which postimmigration experiences are interpreted and potentially given meaning. Qualitative data were obtained from 16 focus groups in California and Massachusetts (N = 93). Fifty-two percent of the participants identified as male and 59% primarily spoke Spanish. Analyses revealed 3 distinct forms of ambivalence specific to familismo among Hispanic adults from immigrant families. Give and take described experiences wherein immigrants turn their backs on family in the short term to realize a better long-term future for the family. Negative change explained family misfortunes that arise in the pursuit of a better future for the family and creates doubts about the vision that motivated migration. Forced shifts suggests the navigation of daily life necessitates the inversion or abandonment of culturally idealized family roles and responsibilities. Hispanic adults from immigrant families described several situations in which competing views of familismo likely influenced the interpretation of unanticipated stressors. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  16. Alcohol Use Severity Among Adult Hispanic Immigrants: Examining the Roles of Family Cohesion, Social Support, and Gender.

    Science.gov (United States)

    Cano, Miguel Ángel; Sánchez, Mariana; Rojas, Patria; Ramírez-Ortiz, Daisy; Polo, Katherine L; Romano, Eduardo; De La Rosa, Mario

    2018-03-21

    This study examined (a) the direct association of family cohesion on alcohol use severity among adult Hispanic immigrants; (b) the indirect association of family cohesion on alcohol use severity via social support; and (c) if gender moderates the direct and indirect associations between family cohesion and alcohol use severity. Mediation and moderation analyses were conducted on a cross-sectional sample of 411 (men = 222, women = 189) participants from Miami-Dade, Florida. Findings indicate that higher family cohesion was directly associated with higher social support and lower alcohol use severity. Higher social support was also directly associated with lower alcohol use severity. Additionally, family cohesion had an indirect association with alcohol use severity via social support. Moderation analyses indicated that gender moderated the direct association between family cohesion and alcohol use severity, but did not moderate the indirect association. Some potential clinical implications may be that strengthening family cohesion may enhance levels of social support, and in turn, lower alcohol use severity among adult Hispanic immigrants. Furthermore, strengthening family cohesion may be especially beneficial to men in efforts to lower levels of alcohol use severity.

  17. Meet the Parents? The Causal Effect of Family Size on the Geographic Distance between Adult Children and Older Parents

    OpenAIRE

    Holmlund, Helena; Rainer, Helmut; Siedler, Thomas

    2009-01-01

    An emerging question in demographic economics is whether there is a link between family size and the geographic distance between adult children and elderly parents. Given current population trends, understanding how different configurations of fam- ily size and sibship influence patterns of child-parent proximity is vitally important, as it impacts on issues such as intergenerational care and everyday mobility. It may be the case, for example, that larger families enable the responsibility of...

  18. Construction of a Family Quality of Life Support Program for families of young and adults with intellectual disability

    Directory of Open Access Journals (Sweden)

    Natxo MARTÍNEZ RUEDA

    2017-02-01

    Full Text Available This paper is grounded on current conceptions on Family Quality of Life (FQoL and family-centered intervention. It describes a part of the building process of a ‘Program for Supporting Family Quality of Life’, within the SAIOA-BBK frame a Gorabide’s information, guidance and support service for people with intellectual disability and their families. A major goal of this project is making proposals for professionals to fit the link between FQoL assessment and its improvement. The program was developed, constructed and tested through collaborative methods between professionals and university researchers, aiming to an increase of FQoL of families with sons or daughters among the youth and adulthood period. Program features, and how it was experimented in a pilot sample of families (n = 5 is presented.

  19. Acute nursing care of the older adult with fragility hip fracture: An international perspective (Part 2)

    LENUS (Irish Health Repository)

    Maher, Ann Butler

    2012-10-23

    The second part of this paper provides those who care for orthopaedic patients with evidence-supported international perspectives about acute nursing care of the older adult with fragility hip fracture. Developed by an international group of nurse experts and guided by a range of information from research and clinical practice, it focuses on nurse sensitive quality indicators during the acute hospitalisation for fragility hip fracture. Optimal care for the patient who has experienced such a fracture is the focus. This includes (in the first, earlier, part):\\r\

  20. Seasonal and Long-term Variations in 137Cs Among Adults from Swedish Hunter Families

    International Nuclear Information System (INIS)

    Agren, G.

    2001-01-01

    To study seasonal variations in 137 Cs, whole-body content measurements of adults from Swedish hunter families have been performed in autumn 1997 and spring 1998. Measurements were performed in three locations, By, Harbo and Gavle, geographically close (within 100 km of each other) but with large differences in ground deposition levels. The hunter families at these three locations were previously measured in 1994. The measured persons were also asked for their frequency of intake of moose, roe-deer, freshwater fish, mushrooms and berries. A statistically significant lower frequency of intake of mushrooms and berries in By, moose, roe-deer and mushrooms in Harbo, and moose in Gavle was found in springtime compared to autumn. In one of the locations, there was a statistically significant lower average 137 Cs whole-body content in spring 1998 than in autumn 1997 while in the other two locations no such effects could be seen. The 137 Cs whole-body content has decreased by 37% from 1994 and to 1998 (including physical decay) correlated to an effective ecological half time of 6 years. (author)

  1. Internal Migration and Life Satisfaction: Well-Being Effects of Moving as a Young Adult

    OpenAIRE

    Switek, Malgorzata

    2012-01-01

    Migration typically leads to higher income, but its association with life satisfaction remains unclear. Is migration accompanied by an increase in life satisfaction? If it is, is the increase in income responsible or are other life domains driving the satisfaction changes? These two questions are addressed using longitudinal data from a Swedish Young Adult Panel Study for 1999 and 2009. Comparing migrants to non-migrants, it is found that internal migration is accompanied by an increase in li...

  2. Familial aggregation of childhood and adult cancer in the Utah genealogy.

    Science.gov (United States)

    Neale, Rachel E; Stiller, Charles A; Bunch, Kathryn J; Milne, Elizabeth; Mineau, Geraldine P; Murphy, Michael F G

    2013-12-15

    A small proportion of childhood cancer is attributable to known hereditary syndromes, but whether there is any familial component to the remainder remains uncertain. We explored familial aggregation of cancer in a population-based case-control study using genealogical record linkage and designed to overcome limitations of previous studies. Subjects were selected from the Utah Population Database. We compared risk of cancer in adult first-degree relatives of children who were diagnosed with cancer with the risk in relatives of children who had not had a cancer diagnosed. We identified 1,894 childhood cancer cases and 3,788 controls; 7,467 relatives of cases and 14,498 relatives of controls were included in the analysis. Relatives of children with cancer had a higher risk of cancer in adulthood than relatives of children without cancer [odds ratio (OR) 1.31, 95% confidence interval (CI) 1.11-1.56]; this was restricted to mothers and siblings and was not evident in fathers. Familial aggregation appeared stronger among relatives of cases diagnosed before 5 years of age (OR 1.48, 95% CI 1.13-1.95) than among relatives of cases who were older when diagnosed (OR 1.22, 95% CI 0.98-1.51). These findings provide evidence of a generalized excess of cancer in the mothers and siblings of children with cancer. The tendency for risk to be higher in the relatives of children who were younger at cancer diagnosis should be investigated in other large data sets. The excesses of thyroid cancer in parents of children with cancer and of any cancer in relatives of children with leukemia merit further investigation. Copyright © 2013 UICC.

  3. Family history, surgery, and APC mutation are risk factors for desmoid tumors in familial adenomatous polyposis: an international cohort study

    DEFF Research Database (Denmark)

    Nieuwenhuis, Marry H; Lefevre, Jérémie H; Bülow, Steffen

    2011-01-01

    Ability to identify patients with familial adenomatous polyposis who have a high risk of developing desmoid tumors may affect decisions in clinical practice.......Ability to identify patients with familial adenomatous polyposis who have a high risk of developing desmoid tumors may affect decisions in clinical practice....

  4. A Look at Person- and Family-Centered Care Among Older Adults: Results from a National Survey [corrected].

    Science.gov (United States)

    Wolff, Jennifer L; Boyd, Cynthia M

    2015-10-01

    Person-centered and family-centered care represents the pinnacle of health care quality, but delivering it is challenging, as is assessing whether it has occurred. Prior studies portray older adults as passive in health decisions and burdened by care-but emphasize age-based differences or focus on vulnerable subgroups. We aimed to examine domains of person-centered and family-centered care among older adults and whether the social context in which older adults manage their health relates to preferences for participating in health decisions and experiences with care. This was an observational study of a nationally representative survey of adults aged 65+ years, conducted in concert with the 2012 National Health and Aging Trends Study (n = 2040). Approach to managing health (self-manage, co-manage, delegate); preferences for making health care decisions with: (1) doctors, (2) family/close friends; and experiences with care pertaining to treatment burden were measured. Approximately two-thirds of older adults self-manage (69.4 %) and one-third co-manage (19.6 %) or delegate (11.0 %) health care activities. The majority prefer an independent or shared role when making health decisions with doctors (84.7 %) and family/close friends (95.9 %). Nearly four in ten older adults (37.9 %) experience treatment burden-that managing health care activities are sometimes or often hard for either them or their family/close friends, that health care activities get delayed or don't get done, or that they are cumulatively too much to do. Relative to older adults who self-manage, those who delegate health care activities are more likely to prefer to share or leave health decisions to doctors (aOR = 1.79 (95 % CI, 1.37-2.33) and family/close friends (aOR = 3.12 (95 % CI, 2.23-4.36), and are more likely to experience treatment burden (aOR = 2.37 (95 % CI, 1.61-3.47). Attaining person-centered and family-centered care will require strategies that respect diverse decision

  5. Death with dignity from the perspective of the surviving family: A survey study among family caregivers of deceased older adults

    NARCIS (Netherlands)

    van Gennip, I.E.; Pasman, H.R.W.; Kaspers, P.J.; Oosterveld-Vlug, M.G.; Willems, D.L.; Deeg, D.J.H.; Onwuteaka-Philipsen, B.D.

    2013-01-01

    Background: Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified

  6. Death with dignity from the perspective of the surviving family: a survey study among family caregivers of deceased older adults

    NARCIS (Netherlands)

    van Gennip, Isis E.; Pasman, H. Roeline W.; Kaspers, Pam J.; Oosterveld-Vlug, Mariska G.; Willems, Dick L.; Deeg, Dorly J. H.; Onwuteaka-Philipsen, Bregje D.

    2013-01-01

    Death with dignity has been identified as important both to patients and their surviving family. While research results have been published on what patients themselves believe may affect the dignity of their deaths, little is known about what family caregivers consider to be a dignified death. (1)

  7. Family caregivers' narratives of mental health treatment usage processes by their Latino adult relatives with serious and persistent mental illness.

    Science.gov (United States)

    Marquez, Jorge A; Ramírez García, Jorge I

    2013-06-01

    Family caregivers' views and experiences related to treatment usage processes by their adult relatives with serious and persistent mental illness (SPMI) were empirically examined in a sample of Latino caregivers (n = 17) who were users of services at the National Alliance on Mental Illness (NAMI) in a predominantly Latino- (80%) and Mexican-descent large city in the Southwest United States. We conducted a stability check of qualitative findings with a second sample of Latino caregivers with no exposure to NAMI (n = 15). Overall, the combined sample (N = 32) compared similarly with larger samples of Latino adults and caregivers in quantitative measures of acculturation, familism, caregiver stigma, and depression symptoms. Together, caregivers' stigma and cultural beliefs, such as vergüenza (shame), use of folk healers, and lack of insurance, were major reported barriers to service usage. Family support (and lack of) for treatment also weighed heavily as a facilitator (and a barrier) of service usage, thus highlighting the complexity of family relationship contexts. Substantial portions of caregivers reported that treatment initiation was prompted by psychiatric hospitalization (50%), and that positive experiences with service providers were influential in treatment retention (72%). Given the high levels of family involvement reported among Latino caregivers, the findings underscore the potential role of family caregivers in treatment engagement and retention. Future research is needed that examines family caregivers' role in treatment with models that consider the interplay between cultural background, family level relationships, and service system contexts. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  8. [Meaning of family confrontation for nurses of intensive care units for adult people - Medellín 2013].

    Science.gov (United States)

    Montoya Tamayo, D P; Monsalve Ospina, T P; Forero Pulido, C

    2015-01-01

    To comprehend the meaning nurses give to family confrontation, from their experiences while patients are in adult intensive care units in Medellin 2013. A qualitative research study was carried out using a phenomenological approach and theoretical convenience sampling of subjects was used. Interviews with open questions were conducted with nurses that worked in different intensive care units in the city of Medellin, with more than one year of experience in these units. The information was coded and categorised to perform the analysis, and some concept maps were created for the final report. This study showed that nurses focus their care on the critical patient and not on the patient's family. They considered that there is family confrontation when its members comprehend the processes that are carried out in the intensive care unit, and can contribute to the patient's care, while if families do not have confrontations, it is because they do not understand the process, or feel desperate or are absent. The interventions that nurses consider must be done to help in the family confrontation are: information, interdisciplinary support, visits, and companionship. For the nurses, family confrontation means that family members understand, comprehend, accept, know, bear and go on with the situation; therefore, they can make good decisions regarding the patient's care in the adult intensive care units. Copyright © 2015 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  9. Behavior of Internal Customer in Family Business: Strategies and Actions for Improving Their Satisfaction.

    Science.gov (United States)

    Gutiérrez-Broncano, Santiago; Jiménez-Estévez, Pedro; Del Carmen Zabala-Baños, María

    2017-01-01

    Determining the relevant aspects of family businesses (FBs) that make them increasingly competitive is the main objective of researchers in this field. Despite this, there is little empirical literature on the behavior of the internal customer (IC) in FBs or how businesses increase their satisfaction. Basing our work on psychological theories and with both quantitative and qualitative information from 31 semi-structured interviews, this work establishes certain characteristics of the ICs of the FB and proposes a series of guidelines for increasing their satisfaction, thereby facilitating the continuity of this type of business. FBs that are able to understand that the motivation of their ICs is more important than other qualities, and that this requires a more comprehensive management will be able to get sustainable competitive advantages in the future.

  10. Behavior of Internal Customer in Family Business: Strategies and Actions for Improving Their Satisfaction

    Science.gov (United States)

    Gutiérrez-Broncano, Santiago; Jiménez-Estévez, Pedro; del Carmen Zabala-Baños, María

    2017-01-01

    Determining the relevant aspects of family businesses (FBs) that make them increasingly competitive is the main objective of researchers in this field. Despite this, there is little empirical literature on the behavior of the internal customer (IC) in FBs or how businesses increase their satisfaction. Basing our work on psychological theories and with both quantitative and qualitative information from 31 semi-structured interviews, this work establishes certain characteristics of the ICs of the FB and proposes a series of guidelines for increasing their satisfaction, thereby facilitating the continuity of this type of business. FBs that are able to understand that the motivation of their ICs is more important than other qualities, and that this requires a more comprehensive management will be able to get sustainable competitive advantages in the future. PMID:28790958

  11. Remission of Maternal Depression: Relations to Family Functioning and Youth Internalizing and Externalizing Symptoms

    Science.gov (United States)

    Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Talati, Ardesheer; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

    2009-01-01

    Family functioning and parenting were hypothesized to mediate the relation between remission of maternal depression and children's psychosocial adjustment. Participants were 114 mother-child dyads participating in the Sequenced Treatment Alternatives to Relieve Depression Child 3-month follow-up. All mothers had been diagnosed with major depressive disorder and were treated initially with citalopram; 33% of mothers experienced remission of depressive symptoms. Youth ranged in age from 7 to 17. Remission of maternal depression was associated with changes in children's reports of their mothers' warmth/acceptance, which in turn partially mediated the relation between maternal depression remission and youth internalizing symptoms, accounting for 22.9% of the variance. PMID:18991123

  12. Lesbian, gay, & bisexual older adults: linking internal minority stressors, chronic health conditions, and depression.

    Science.gov (United States)

    Hoy-Ellis, Charles P; Fredriksen-Goldsen, Karen I

    2016-11-01

    This study aims to: (1) test whether the minority stressors disclosure of sexual orientation; and (2) internalized heterosexism are predictive of chronic physical health conditions; and (3) depression; (4) to test direct and indirect relationships between these variables; and (5) whether chronic physical health conditions are further predictive of depression, net of disclosure of sexual orientation and internalized heterosexism. Secondary analysis of national, community-based surveys of 2349 lesbian, gay, and bisexual adults aged 50 and older residing in the US utilizing structural equation modeling. Congruent with minority stress theory, disclosure of sexual orientation is indirectly associated with chronic physical health conditions and depression, mediated by internalized heterosexism with a suppressor effect. Internalized heterosexism is directly associated with chronic physical health conditions and depression, and further indirectly associated with depression mediated by chronic physical health conditions. Finally, chronic physical health conditions have an additional direct relationship with depression, net of other predictor variables. Minority stressors and chronic physical health conditions independently and collectively predict depression, possibly a synergistic effect. Implications for depression among older sexual minority adults are discussed.

  13. Monitoring of international normalized ratios: comparison of community nurses with family physicians.

    Science.gov (United States)

    Levine, Max A; Shao, Wei; Klein, Douglas

    2012-08-01

    To determine whether community-based, nurse-led monitoring of the international normalized ratio (INR) in patients requiring long-term warfarin therapy was comparable to traditional physician monitoring. A retrospective cohort analysis of patients taking long-term warfarin therapy. The study used data gathered from 3 family medicine clinics in a primary care network in Edmonton, Alta. Medical records of patients currently taking warfarin were examined. Implementation of nurse-led monitoring in a primary care network in place of standard family physician INR monitoring. The degree of INR control before and after the implementation of nurse-run INR monitoring was assessed. The average proportion of time spent outside of therapeutic INR ranges, as well as the average number of days between successive INR readings, was calculated and compared. The degree of control placed patients into either a good-control group (out of range ≤ 25% of the time) or a moderate-control group (out of range > 25% of the time) and these groups were compared. Before nurse monitoring, INR values were out of range 20.4% of the time; after nurse monitoring they were out of range 19.2% of the time (P = .115); the time between sequential INR readings also did not differ before and after implementation of nurse monitoring (23.9 vs 21.6 days, P = .789). Nurse-led monitoring of INR is as effective as traditional physician monitoring. Advantages of nurse-led monitoring might include freeing family physicians to see more patients or to spend less time at work. It might also represent potential cost savings.

  14. A mixed methods exploration of family involvement in medical care for older adults with serious mental illness

    NARCIS (Netherlands)

    Aschbrenner, K.A.; Pepin, R.; Mueser, K.T.; Naslund, J.A.; Rolin, S.A.; Faber, M.J.; Bartels, S.J.

    2014-01-01

    OBJECTIVE: Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received

  15. Perceived Family Support and Self-Esteem: The Mediational Role of Emotional Experience in Adults with Dyslexia

    Science.gov (United States)

    Nalavany, Blace A.; Carawan, Lena W.

    2012-01-01

    Although a growing body of literature shows that perceived family support (PFS) influences self-esteem in adults with dyslexia, little empirical attention has been given to the mechanisms through which this effect operates across early, middle, and late adulthood. The present study examined the mediational effect of emotional experience with…

  16. Evaluation of Seafood Product Concepts by Young Adults and Families with Young Children from Denmark, Norway, and Iceland

    NARCIS (Netherlands)

    Altintzoglou, T.; Sveinsdottir, K.; Einarsdottir, G.; Schelvis, R.; Luten, J.B.

    2012-01-01

    This article describes the results of a study that tested the responses to 14 seafood concepts among young adults and families with young children in Denmark, Norway, and Iceland. This study was aimed at gaining insight into the evaluation of new seafood product concepts by individuals with low

  17. Vitamin D status and its determinants in children and adults among families in late summer in Denmark

    DEFF Research Database (Denmark)

    Madsen, Katja Howarth; Rasmussen, Lone Banke; Mejborn, Heddie

    2014-01-01

    (56°N). Data obtained from 755 apparently healthy children (4-17 years) and adults (18-60 years) recruited as families (n 200) in the VitmaD study were analysed. Blood samples were collected in September-October, and serum 25(OH)D concentration was measured by liquid chromatography-tandem MS...

  18. Post-traumatic stress disorder symptoms in family caregivers of adult patients with acute leukemia from a dyadic perspective.

    Science.gov (United States)

    Jia, Mutian; Li, Jie; Chen, Chunyan; Cao, Fenglin

    2015-12-01

    Acute leukemia is a fatal disease in adults that not only affects the patients who suffer from it but also their family caregivers. No studies have investigated post-traumatic stress disorder symptoms (PTSS) in family caregivers of adult patients with acute leukemia using a matched sample. The current study examined PTSS in adult patients with acute leukemia and their family caregivers and investigated the factors associated with caregivers' PTSS. A total of 163 patient-caregiver dyads completed questionnaires assessing their PTSS, psychological resilience, and perceived social support. Hierarchical linear regression was used to explore the related factors of caregivers' PTSS. More caregivers than patients met caseness criteria for PTSS (36.8% vs. 18.4%, p caregivers, being more closely related to the patients (e.g., spouses and parents), having patients with higher PTSS and having lower psychological resilience were independently associated with more severe PTSS. Caregivers of acute leukemia patients had significantly more severe PTSS than did their patients. This study is the first to investigate PTSS among family caregivers of adult patients with acute leukemia and its related factors in a matched sample. More attention should be paid to the caregivers of patients with acute leukemia to minimize their PTSS and thus improve mental health of caregivers and reduce potential negative consequences for the patients themselves. Copyright © 2015 John Wiley & Sons, Ltd.

  19. The evaluation of family functioning by the family assessment device: a systematic review of studies in adult clinical populations.

    Science.gov (United States)

    Staccini, Laura; Tomba, Elena; Grandi, Silvana; Keitner, Gabor I

    2015-03-01

    A large body of research, documenting the impact of a family's functioning on health outcomes, highlights the importance of introducing the evaluation of patients' family dynamics into clinical judgment. The Family Assessment Device (FAD) is a self-report questionnaire designed to assess specific dimensions of family functioning. This qualitative systematic review, which follows PRISMA guidelines, aimed to identify the FAD's clinimetric properties and to report the incremental utility of its inclusion in clinical settings. A thorough literature search was performed, using both computerized and manual searches, yielding a total of 148 studies that were included in this review. The FAD has been extensively used in a variety of research contexts. In the majority of studies it was able to discriminate between clinical populations and controls and among groups of patients with different illnesses. The FAD also showed good test-retest and concurrent reliability, and modest sensitivity to change after treatment. FAD-dysfunctional family functioning was related to several patient clinical outcomes, including lower recovery rates and adherence to treatment, longer recovery time, poorer quality of life, and increased risk of relapse and drop-out. The present review demonstrates that the FAD is a suitable instrument for the evaluation of family functioning both in clinical and research settings. © 2014 Family Process Institute.

  20. Experiences of adults with high-care needs and their family members with housing and support pathways in Australia.

    Science.gov (United States)

    McIntyre, Deborah; Fleming, Jennifer; Foster, Michele; Tweedy, Sean

    2017-09-01

    Many adults aged less than 65 years with high-care needs resulting from acquired disabilities are unable to access age-appropriate housing and support, and reside in residential aged care or live with family members who may struggle to navigate the disability support system. This qualitative study aimed to investigate the experiences of adults with high-care needs and their family members regarding pathways related to housing and support. Two in-depth semi-structured interviews were conducted six months apart with 21 people aged 18 to 65 with high-care needs of varying etiology and living in different housing settings. Nineteen family members involved in decision-making about housing and supports were also interviewed. Thematic data analysis yielded five themes: (1) Traveling in different directions; (2) "the fight, the battle and the war"; (3) willing but wanting; (4) uncertainty and vulnerability; and (5) redefining social roles and relationships. Current disability policy is not satisfying the housing and support requirements of adults with high-care needs and their families. The findings provide rigorous, empirical evidence which indicate the urgent need to improve access to affordable, individualized housing and support packages, including financial, practical and informational support for family members involved in caring roles. Implications for Rehabilitation Individual preferences are an important consideration in housing and support arrangements for younger people with high-care needs alongside needs-based solutions. Individualized funding approaches may provide flexibility of care and choice in housing and support for people with disability. Family members willingly provide substantial informal care, support and advocacy for younger people with high needs but perceive their role as a constant "battle". Payment of family members in recognition of caring work was perceived as a solution to relieve family hardship and ensure optimal care.

  1. How well are we doing? Families of adolescents or young adults with cerebral palsy share their perceptions of service delivery.

    Science.gov (United States)

    Darrah, J; Magil-Evans, J; Adkins, R

    2002-07-10

    The satisfaction of families of adolescents and young adults with a diagnosis of cerebral palsy with the service delivery they had experienced in the areas of health, education, recreation, employment, housing and transportation was examined. Common themes across the six service areas were identified. Forty-nine adolescents (13-15 years) and 39 young adults (19-23 years) and their families rated their satisfaction with services and then participated in semi-structured interviews to discuss their experiences. Using a constant comparative method of analysis, common themes were identified from the transcribed interviews. Four themes were identified and named: caring and supportive people; fighting and fatigue; communication/information; and disability awareness. Families continue to experience dissatisfaction and frustration with service delivery in the six areas examined. Both bureaucratic structure and attitudes of service providers contribute to their dissatisfaction.

  2. Brief Report: What Happens When I Can No Longer Support My Autistic Relative? Worries about the Future for Family Members of Autistic Adults

    Science.gov (United States)

    Herrema, Renske; Garland, Deborah; Osborne, Malcolm; Freeston, Mark; Honey, Emma; Rodgers, Jacqui

    2017-01-01

    Very little is known about autism and adulthood. Family members are often the primary support for autistic adults and frequently express concerns about what the future will hold and what support will be available for their relative. 120 family members of autistic adults completed an online survey exploring concerns about the future for their…

  3. Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali

    OpenAIRE

    Gold, Judy; Burke, Eva; Ciss?, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan

    2017-01-01

    Background: Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Program Description: Potential franchisees are generally identified from CSCOMs who have worked with MSI outrea...

  4. Shared meals among young adults are associated with better diet quality and predicted by family meal patterns during adolescence.

    Science.gov (United States)

    Larson, Nicole; Fulkerson, Jayne; Story, Mary; Neumark-Sztainer, Dianne

    2013-05-01

    To describe shared meal patterns and examine associations with dietary intake among young adults. Population-based, longitudinal cohort study (Project EAT: Eating and Activity in Teens and Young Adults). Participants completed surveys and FFQ in high-school classrooms in Minneapolis/St. Paul, MN, USA in 1998-1999 (mean age = 15·0 years, 'adolescence') and follow-up measures online or by mail in 2008-2009 (mean age = 25·3 years, 'young adulthood'). There were 2052 participants who responded to the 10-year follow-up survey and reported on frequency of having shared meals. Among young adults, the frequency of shared meals during the past week was as follows: never (9·9 %), one or two times (24·7 %), three to six times (39·1 %) and seven or more times (26·3 %). Having more frequent family meals during adolescence predicted a higher frequency of shared meals in young adulthood above and beyond other relevant sociodemographic factors such as household composition and parental status. Compared with young adults who never had family meals during adolescence, those young adults who reported seven or more family meals per week during adolescence had an average of one additional shared meal per week. Having more frequent shared meals in young adulthood was associated with greater intake of fruit among males and females, and with higher intakes of vegetables, milk products and some key nutrients among females. Nutrition professionals should encourage families of adolescents to share meals often and establish the tradition of eating together, and work with young adults to ensure that healthy food and beverage choices are offered at mealtimes.

  5. Impact of international humanitarian service-learning on emerging adult social competence: A mixed-methods evaluation

    Directory of Open Access Journals (Sweden)

    Paul Schvaneveldt

    2016-09-01

    Full Text Available This article presents the results from a study into international humanitarian service-learning experiences on young adult volunteers. Specifically, the service-learning experiences of emerging adults who had served in orphanages in Latin America were assessed, in a pre- and post-test design, for their development in areas of social competency such as identity, self-efficacy, self-esteem and ethnocentric attitudes. A mixed-methods design using both qualitative and quantitative measures was used. Both qualitative and quantitative results identified significant and important impacts on the development of the social competencies of these emerging adults. In addition, several qualitative themes illustrated that longer term international service-learning experiences have a profound impact on the social competence of emerging adults. Keywords: International humanitarian service, service-learning, emerging adult competency

  6. Update of the ERS international Adult Respiratory Medicine syllabus for postgraduate training.

    Science.gov (United States)

    Tabin, Nathalie; Mitchell, Sharon; O'Connell, Elaine; Stolz, Daiana; Rohde, Gernot

    2018-03-01

    First published in 2006, the first European core syllabus in Adult Respiratory Medicine was developed with the intention of harmonising education and training throughout Europe. Internationally recognised by the European Union of Medical Specialists and identified as the first document of its kind in respiratory medicine, it has provided a comprehensive guide for both local and national institutions in the development of adult respiratory training programmes. Like all fields in education, respiratory medicine is an ever-changing area and as such, respective syllabi, curricula and training programmes must adapt and diversify in line with the evolution of core medical concepts. Given the proven importance of the Adult Respiratory Medicine syllabus from both a national and international standpoint, it is of equal importance that said syllabus remains abreast of emerging trends so as to sustain the synchronisation of respiratory medicine in Europe. In order to develop an updated programme, a comprehensive review process of the current syllabus is a necessary endeavour and a step that the European Respiratory Society (ERS) has undertaken through the process of a needs assessment.

  7. Trajectories of caregiver burden in families of adult cystic fibrosis patients.

    Science.gov (United States)

    Wojtaszczyk, Ann; Glajchen, Myra; Portenoy, Russell K; Berdella, Maria; Walker, Patricia; Barrett, Malcolm; Chen, Jack; Plachta, Amy; Balzano, Julie; Fresenius, Ashley; Wilder, Kenya; Langfelder-Schwind, Elinor; Dhingra, Lara

    2017-10-17

    Little is known about the experience of family caregivers of adults with cystic fibrosis (CF). This information is important for the identification of caregivers at risk for burden. This was a longitudinal analysis of survey data obtained from caregivers of adult CF patients participating in an early intervention palliative care trial. Caregivers completed the validated Brief Assessment Scale for Caregivers (BASC) repeatedly over a 28-month period. Mixed-effects modeling evaluated multivariate associations with positive and negative caregiver perceptions over time. Of the 54 caregivers, 47.9% were spouses. The mean age was 50.9 years (SD = 13.2); 72.2% were women; 75.9% were married; and 63.0% were employed. At baseline, the BASC revealed large variations in positive and negative perceptions of caregiving. Although average scores over time were unchanging, variation was greater across caregivers than within caregivers (0.49 vs. 0.27, respectively). At baseline, the positive impact of caregiving in the sample was higher than the negative impact. Multivariate analysis revealed that patients' baseline pulmonary function and their full-time employment status predicted caregiver burden over time. Caregivers of CF patients varied in their positive and negative caregiving experiences, although burden levels in individual caregivers were stable over time. When the disease was advanced, caregivers of CF patients experienced more overall burden but also more positive impact. This suggests that the role of caregivers may become more meaningful as disease severity worsens. In addition, full-time patient employment was associated with lower caregiver burden regardless of disease severity. This suggests that burden in CF caregivers may be predicted by financial strain or benefits conferred by patient employment. These associations require further investigation to determine whether highly burdened caregivers can be identified and assisted using tailored interventions.

  8. Screening for depressive symptoms in older adults in the Family Health Strategy, Porto Alegre, Brazil.

    Science.gov (United States)

    Nogueira, Eduardo Lopes; Rubin, Leonardo Librelotto; Giacobbo, Sara de Souza; Gomes, Irenio; Cataldo Neto, Alfredo

    2014-06-01

    OBJECTIVE To analyze the prevalence of depression in older adults and associated factors. METHODS Cross-sectional study using a stratified random sample of 621 individuals aged ≥ 60 from 27 family health teams in Porto Alegre, RS, Southern Brazil, between 2010 and 2012. Community health agents measured depression using the 15-item Geriatric Depression Scale. Scores of ≥ 6 were considered as depression and between 11 and 15 as severe depression. Poisson regression was used to search for independent associations of sociodemographic and self-perceived health with both depression and its severity. RESULTS The prevalence of depression was 30.6% and was significantly higher in women (35.9% women versus 20.9% men, p education, especially illiteracy (PR = 1.8, 95%CI 1.2;2 6); regular self-rated health (OR = 2.2, 95%CI 1.6;3.0); and poor/very poor self-rated health (PR = 4.0, 95%CI 2.9;5.5). Except for education, the strength of association of these factors increases significantly in severe depression. CONCLUSIONS A high prevalence of depression was observed in the evaluations conducted by community health agents, professionals who are not highly specialized. The findings identified using the 15-item Geriatric Depression Scale in this way are similar to those in the literature, with depression more associated with low education, female gender and worse self-rated health. From a primary health care strategic point of view, the findings become still more relevant, indicating that community health agents could play an important role in identifying depression in older adults.

  9. Identifying frailty in primary care: a qualitative description of family physicians' gestalt impressions of their older adult patients.

    Science.gov (United States)

    Korenvain, Clara; Famiyeh, Ida-Maisie; Dunn, Sheila; Whitehead, Cynthia R; Rochon, Paula A; McCarthy, Lisa M

    2018-05-14

    Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses. Descriptive qualitative study of family physicians who practice in a large urban academic family medicine center as they participated in one-on-one "think-aloud" interviews about the frailty status of their patients aged 80 years and over. Of 23 eligible family physicians, 18 shared their impressions about the frailty status of their older adult patients and the factors influencing their decisions. Interviews were audio-recorded, transcribed, and thematically analyzed. Four themes were identified, the first of which described how physicians conceptualized frailty as a spectrum and dynamic in nature, but also struggled to conceptualize it without a formal definition in place. The remaining three themes described factors considered before determining patients' frailty statuses: physical characteristics (age, weight, medical conditions), functional characteristics (physical, cognitive, social) and living conditions (level of independence, availability of supports, physical environment). Family physicians viewed frailty as multifactorial, dynamic, and inclusive of functional and environmental factors. This conceptualization can be useful to make comprehensive and flexible evaluations of frailty status in conjunction with more objective frailty tools.

  10. "Fighting the system": Families caring for ventilator-dependent children and adults with complex health care needs at home

    Directory of Open Access Journals (Sweden)

    Nielsen Erik W

    2011-07-01

    Full Text Available Abstract Background An increasing number of individuals with complex health care needs now receive life-long and life-prolonging ventilatory support at home. Family members often take on the role of primary caregivers. The aim of this study was to explore the experiences of families giving advanced care to family members dependent on home mechanical ventilation. Methods Using qualitative research methods, a Grounded Theory influenced approach was used to explore the families' experiences. A total of 15 family members with 11 ventilator-dependent individuals (three children and eight adults were recruited for 10 in-depth interviews. Results The core category, "fighting the system," became the central theme as family members were asked to describe their experiences. In addition, we identified three subcategories, "lack of competence and continuity", "being indispensable" and "worth fighting for". This study revealed no major differences in the families' experiences that were dependent on whether the ventilator-dependent individual was a child or an adult. Conclusions These findings show that there is a large gap between family members' expectations and what the community health care services are able to provide, even when almost unlimited resources are available. A number of measures are needed to reduce the burden on these family members and to make hospital care at home possible. In the future, the gap between what the health care can potentially provide and what they can provide in real life will rapidly increase. New proposals to limit the extremely costly provision of home mechanical ventilation in Norway will trigger new ethical dilemmas that should be studied further.

  11. Parental verbal abuse and the mediating role of self-criticism in adult internalizing disorders.

    Science.gov (United States)

    Sachs-Ericsson, Natalie; Verona, Edelyn; Joiner, Thomas; Preacher, Kristopher J

    2006-07-01

    Researchers (e.g., [Gibb, B.E., 2002. Childhood maltreatment and negative cognitive styles. A quantitative and qualitative review. Clinical Psychology Review, 22 (2), 223-246]; [Rose, D.T., Abramson, L.Y., 1992. Developmental predictors of depressive cognitive styles: developmental perspectives on depression. In Cicchetti, D., Toth, S.L. (Eds.), Developmental Perspectives on Depression. Rochester symposium on developmental psychopathology, vol. 4, pp. 323-349]) have proposed that when childhood abuse is verbal (rather than sexual or physical), the child is more likely to develop a negative self-schema because the negative self-cognitions are directly supplied to the child by the abuser (e.g., "you are stupid"). In a test of this theory in adult participants, and drawing on the National Comorbidity Survey (NCS) (N=5877), we investigate the mediating role of current levels of self-criticism on the relationship between retrospective reports of parental verbal abuse, as well as sexual and physical abuse, and adult internalizing symptoms. We found self-criticism, but not dependency traits, to fully mediate the relationship between childhood verbal abuse perpetrated by parents and internalizing (depression, anxiety) symptoms. On the other hand, self-criticism was only a partial mediator of the relationship between the other types of abuse and internalizing symptoms. The NCS data is cross-sectional, which limits any firm conclusions regarding causality. While these results are suggestive that self-criticism is a mediator of the relationship between abuse and internalizing symptoms, longitudinal data are necessary to help rule out alternative explanations. Results of this study suggest that childhood abuse experiences, and in particular verbal abuse, may confer risk for internalizing disorders in part because verbal abuse influences the development of a self-critical style.

  12. Construct validity and internal consistency in the Leisure Practices Scale (EPL) for adults.

    Science.gov (United States)

    Andrade, Rubian Diego; Schwartz, Gisele Maria; Tavares, Giselle Helena; Pelegrini, Andreia; Teixeira, Clarissa Stefani; Felden, Érico Pereira Gomes

    2018-02-01

    This study proposes and analyzes the construct validity and internal consistency of the Leisure Practices Scale (EPL). This survey seeks to identify the preferences and involvement in in different leisure practices in adults. The instrument was formed based on the cultural leisure content (artistic, manual, physical, sports, intellectual, social, tourist, virtual and contemplation/leisure). The validation process was conducted with: a) content analysis by leisure experts, who evaluated the instrument for clarity of language and practical relevance, which allowed the calculation of the content validity coefficient (CVC); b) reproducibility test-retest with 51 subjects to calculate the temporal variation coefficient; c) internal consistency analysis with 885 participants. The evaluation presented appropriate coefficients, both with respect to language clarity (CVCt = 0.883) and practical relevance (CVCt = 0.879). The reproducibility coefficients were moderate to excellent. The scale showed adequate internal consistency (0.72). The EPL has psychometric quality and acceptable values in its structure, and can be used to investigate adult involvement in leisure activities.

  13. The Role of International Non-Governmental Organisations in Promoting Adult Education for Social Change: A Research Agenda

    Science.gov (United States)

    Hoff, Lutz; Hickling-Hudson, Anne

    2011-01-01

    This paper explores the role of International Non-Governmental Organisations (INGOs) in adult education as one instrument of global civil society to effect social change. Postcolonial theory is utilized to explore the complex relationships between the concepts of "globalisation", "global civil, society", and "adult education for social change". In…

  14. The Prediction of Labor Force Status: Implications from International Adult Skill Assessments. Research Report. ETS RR-16-11

    Science.gov (United States)

    Li, Tongyun; von Davier, Matthias; Hancock, Gregory R.

    2016-01-01

    This report investigates the prediction of labor force status using observed variables, such as gender, age, and immigrant status, and more importantly, measured skill variables, including literacy proficiency and a categorical rating of educational attainment based on the 1994 International Adult Literacy Survey (IALS), the 2003 Adult Literacy…

  15. Childhood family structure and women's adult overweight risk: A longitudinal study.

    Science.gov (United States)

    Chaparro, M Pia; de Luna, Xavier; Häggström, Jenny; Ivarsson, Anneli; Lindgren, Urban; Nilsson, Karina; Koupil, Ilona

    2017-07-01

    The aim of this study was to investigate whether women's adult overweight and obesity risk was associated with their childhood family structure, measured as their mothers' marital status history, during the women's first 18 years of life. Using linked register data, we analyzed 30,584 primiparous women born in Sweden in 1975 who were between 19-35 years of age when their height and pre-pregnancy weight was recorded. The outcomes were women's overweight/obesity (body mass index (BMI) ≥ 25 kg/m 2 ) and obesity (BMI ≥ 30 kg/m 2 ) and the predictor was mothers' marital status history, which was summarized using sequence analysis. We carried out nested logistic regression models adjusting for women's age and maternal sociodemographic characteristics. Mothers' marital status history was summarized into six clusters: stable marriage, stable cohabitation, married then divorcing, cohabiting then separating, varied transitions, and not with father. In fully adjusted models and compared with women whose mothers belonged to the stable marriage cluster: (1) women whose mothers belonged to the other marital status clusters had higher odds of overweight/obesity (odds ratio (OR) ranging 1.15-1.19; p overweight or obese in adulthood. The finding that even women raised in the context of stable cohabitation had higher odds of being overweight or obese is intriguing as these relationships are socially accepted in Sweden.

  16. When play is a family business: adult play, hierarchy, and possible stress reduction in common marmosets.

    Science.gov (United States)

    Norscia, Ivan; Palagi, Elisabetta

    2011-04-01

    Easy to recognize but not easy to define, animal play is a baffling behavior because it has no obvious immediate benefits for the performers. However, the absence of immediate advantages, if true, would leave adult play (costly but maintained by evolution, spanning lemurs to Homo sapiens) unexplained. Although a commonly held view maintains that play is limited by stress, an emergent hypothesis states that play can regulate stress in the short term. Here we explored this hypothesis in a captive family group of New World monkeys, Callithrix jacchus (common marmoset). We observed six subjects and gathered data on aggressive, play, and scratching behavior via focal (6 h/individual) and all occurrences sampling (115 h). We found that play levels were highest during pre-feeding, the period of maximum anxiety due to the forthcoming competition over food. Scratching (the most reliable indicator of stress in primates) and play showed opposite trends along hierarchy, with dominants scratching more and playing less than subordinates. Finally, scratching decreased after play, whereas play appeared to be unrelated to previous scratching events, symptoms of a potential stressful state. In conclusion, both play timing and hierarchical distribution indicate that play limits stress, more than vice versa, at least in the short term.

  17. Family meal frequency, weight status and healthy management in children, young adults and seniors. A study in Sardinia, Italy.

    Science.gov (United States)

    Nuvoli, Gianfranco

    2015-06-01

    To examine family meal frequency, and weight management as a protective factor throughout life. Selected by city and by town in Sardinia (Italy), the 522 participants were divided into 162 children (7-11 years), 187 young adults (19-30 years), and 173 seniors (65-90 years). Chi-square analyses were used to compare the frequency of family meals, weight (self-reported and perceived) and healthy management (physical activity, dieting, perceived appetite) between age groups. In addition, multinomial regression analyses were carried out to find associations, with age group as the dependent variable and frequency of family meal, weight status, and healthy management categories as independent variables, adjusted for moderating effects. Significant associations with age variables were observed in mealtime frequency (skipping breakfast and mid-morning snack in adults and lunch in children and seniors), in decreasing self-reported normal weight with age and increasing perceived overweight with age, and in physical activity, dieting and perceived appetite. The results suggest the protective nature of family meals for adults and seniors, and identify significant associations (and some differences) between age groups. Discrepancies suggest the importance of education about body weight awareness throughout life. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Resilience as a concept for understanding family caregiving of adults with Chronic Obstructive Pulmonary Disease (COPD): an integrative review.

    Science.gov (United States)

    Rosa, Francesca; Bagnasco, Annamaria; Aleo, Giuseppe; Kendall, Sally; Sasso, Loredana

    2017-04-01

    This paper was a report of the synthesis of evidence on examining the origins and definitions of the concept of resilience, investigating its application in chronic illness management and exploring its utility as a means of understanding family caregiving of adults with Chronic Obstructive Pulmonary Disease. Resilience is a concept that is becoming relevant to understanding how individuals and families live with illness, especially long-term conditions. Caregivers of adults with Chronic Obstructive Pulmonary Disease must be able to respond to exacerbations of the condition and may themselves experience cognitive imbalances. Yet, resilience as a way of understanding family caregiving of adults with COPD is little explored. Literature review - integrative review. CINAHL, PubMed, Google Scholar and EBSCO were searched between 1989-2015. The principles of rapid evidence assessment were followed. We identified 376 relevant papers: 20 papers reported the presence of the concept of resilience in family caregivers of chronic diseases patients but only 12 papers reported the presence of the concept of resilience in caregivers of Chronic Obstructive Pulmonary Disease patients and have been included in the synthesis. The term resilience in Chronic Obstructive Pulmonary Disease caregiving is most often understood using a deficit model of health.

  19. International perspectives on work-family policies: lessons from the world's most competitive economies.

    Science.gov (United States)

    Earle, Alison; Mokomane, Zitha; Heymann, Jody

    2011-01-01

    The United States does not guarantee families a wide range of supportive workplace policies such as paid maternity and paternity leave or paid leave to care for sick children. Proposals to provide such benefits are invariably met with the complaint that the costs would reduce employment and undermine the international competitiveness of American businesses. In this article, Alison Earle, Zitha Mokomane, and Jody Heymann explore whether paid leave and other work-family policies that support children's development exist in countries that are economically competitive and have low unemployment rates. Their data show that the answer is yes. Using indicators of competitiveness gathered by the World Economic Forum, the authors identify fifteen countries, including the United States, that have been among the top twenty countries in competitiveness rankings for at least eight of ten years. To this group they add China and India, both rising competitors in the global economy. They find that every one of these countries, except the United States, guarantees some form of paid leave for new mothers as well as annual leave. And all but Switzerland and the United States guarantee paid leave for new fathers. The authors perform a similar exercise to identify thirteen advanced countries with consistently low unemployment rates, again including the United States. The majority of these countries provide paid leave for new mothers, paid leave for new fathers, paid leave to care for children's health care needs, breast-feeding breaks, paid vacation leave, and a weekly day of rest. Of these, the United States guarantees only breast-feeding breaks (part of the recently passed health care legislation). The authors' global examination of the most competitive economies as well as the economies with low unemployment rates makes clear that ensuring that all parents are available to care for their children's healthy development does not preclude a country from being highly competitive

  20. Predictors of Family Conflict at the End of Life: The Experience of Spouses and Adult Children of Persons with Lung Cancer

    Science.gov (United States)

    Kramer, Betty J.; Kavanaugh, Melinda; Trentham-Dietz, Amy; Walsh, Matthew; Yonker, James A.

    2010-01-01

    Purpose: Guided by an explanatory matrix of family conflict at the end of life, the purpose of this article was to examine the correlates and predictors of family conflict reported by 155 spouses and adult children of persons with lung cancer. Design and Methods: A cross-sectional statewide survey of family members of persons who died from lung…

  1. Assessment of breathing rate of adult Korean for use in internal dosimetry

    International Nuclear Information System (INIS)

    Kim, J.I.; Lee, Y.J.; Jin, Y.W.; Kim, C.S.; Lee, J.K.

    2003-01-01

    Breathing rate is one of the key factors in evaluating doses due to inhalation of airborne radionuclides. Since the reference values of breathing rate provided by the International Commission on Radiological Protection (ICRP) are based on the physiology of Caucasian, they are not necessarily appropriate for internal dosimetry for Korean. In this study, we assessed breathing rate of Korean by measuring the forced vital capacity (FVC), the forced expiratory volume in second (FEV1) and the minute ventilation(MV). Measurements were made using SP-1 spirometry unit (Schiller AG. 1998) for 1474 adult Koreans whose heights and weights are in the range of one standard deviation from the mean values. The total liters of air breathed for working and resting were evaluated after the ICRP approach. We also considered smoking and ailment in the lungs. The resulting breathing rate appears to be 2.3x10 4 L/day which well agrees with the value given in ICRP 23

  2. Silent internal sinus of the pyriform fossa: a rare adult manifestation of a branchial anomaly.

    Science.gov (United States)

    Lin, Chao-Jung; Lin, Yaoh-Shiang; Kang, Bor-Hwang; Lee, Jin-Chin

    2003-03-01

    Branchial anomalies present with a wide range of pathologic characteristics, including cysts, fistulas, and sinuses of the head and neck region. Branchial cysts are most commonly diagnosed during the second through fourth decades of life, while branchial sinuses and fistulas are diagnosed almost exclusively in children with infection episodes. Only rarely has an internal sinus of a third or fourth branchial anomaly manifested in adults as a noninfectious swelling in the neck during swallowing. In this report, we describe our experience treating a 21-year-old man with a left-sided swallowing-induced neck protrusion of 10 years' duration. Findings of physical examination, videolaryngoscopy, and a pharyngoesophagogram confirmed the diagnosis of internal sinus of the pyriform fossa, with uncertain origin of a third or fourth branchial anomaly. The patient underwent regular follow-up as an outpatient and experienced no further infectious episodes.

  3. Do current national and international guidelines have specific recommendations for older adults with bipolar disorder?

    DEFF Research Database (Denmark)

    Dols, Annemiek; Kessing, Lars Vedel; Strejilevich, Sergio A

    2016-01-01

    a variety of sources have become available in recent years. It is expected that at least some of this emerging information on OABD would be incorporated into treatment guidelines available to clinicians around the world. METHODS: The International Society of Bipolar Disorders OABD task force compiled...... and compared recommendations from current national and international guidelines that specifically address geriatric or older individuals with BD (from year 2005 onwards). RESULTS: There were 34 guidelines, representing six continents and 19 countries. The majority of guidelines had no separate section on OABD....... General principles for treating OABD with medication are recommended to be similar to those for younger adults, with special caution for side effects due to somatic comorbidity and concomitant medications. Therapeutic lithium serum levels are suggested to be lower but recommendations are very general...

  4. Epidemiology of atopic dermatitis in adults: Results from an international survey.

    Science.gov (United States)

    Barbarot, S; Auziere, S; Gadkari, A; Girolomoni, G; Puig, L; Simpson, E L; Margolis, D J; de Bruin-Weller, M; Eckert, L

    2018-01-10

    There are gaps in our knowledge of the prevalence of adult atopic dermatitis (AD). To estimate the prevalence of AD in adults and by disease severity. This international, cross-sectional, web-based survey was performed in the United States, Canada, France, Germany, Italy, Spain, United Kingdom, and Japan. Adult members of online respondent panels were sent a questionnaire for AD identification and severity assessment; demographic quotas ensured population representativeness for each country. A diagnosis of AD required subjects to be positive on the modified UK Working Party/ISAAC criteria and self-report of ever having an AD diagnosis by a physician. The proportion of subjects with AD who reported being treated for their condition was determined and also used to estimate prevalence. Severity scales were Patient-Oriented SCORAD, Patient-Orientated Eczema Measure, and Patient Global Assessment. Among participants by region, the point prevalence of adult AD in the overall/treated populations was 4.9%/3.9% in the US, 3.5%/2.6% in Canada, 4.4%/3.5% in the EU, and 2.1%/1.5% in Japan. The prevalence was generally lower for males vs females, and decreased with age. Regional variability was observed within countries. Severity varied by scale and region; however, regardless of the scale or region, proportion of subjects reporting severe disease was lower than mild or moderate disease. Prevalence of adult AD ranged from 2.1% to 4.9% across countries. Severe AD represented a small proportion of the overall AD population regardless of measure or region. © 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  5. Older adults' influence in family care: how do daughters and aging parents navigate differences in care goals?

    Science.gov (United States)

    Heid, Allison R; Zarit, Steven H; Van Haitsma, Kimberly

    2016-01-01

    This study seeks to address how older adults influence their daily care when their preferences conflict with those of their adult daughter caregivers. Using a sample of 10 dyads (N = 20) of an older adult and adult daughter, we utilize content analysis strategies to analyze in-depth, semi-structured interview data with QSR NVIVO to investigate how older adults influence their care, how daughters respond to such efforts of influence, and how dyads navigate differences in care goals. When there is agreement in goals, dyads report tasks going well and both individuals' requests are honored. When there are differences in care goals, daughters most frequently reason with their older parents, while parents walk away or 'let go' of their requests. Daughters report making decisions for their parents for health or safety-related needs. However, all dyads discuss differences in care goals, whereby parents are perceived as insisting, resisting, or persisting in care. Findings illustrate complex patterns of responses by families when navigating differences in daily care goals that carry important implications for research and the development of dyadic-based family interventions.

  6. ‘Reaching Out’: international models for transitional care for teenage and young adult cancer patients

    Directory of Open Access Journals (Sweden)

    Charlotte Weston

    2018-05-01

    Full Text Available Background: This article will give an overview of ‘Reaching Out’, a project to identify international models of transitional care for adolescent and young adult (AYA cancer patients. Aims: •\tExplore provision of AYA cancer care in a different cultural context •\tIdentify new models of care for supporting transition between paediatric, AYA and adult care, and between acute and primary care •\tIdentify relevant resources and service designs that could be adapted for use in AYA services in the UK Methods: Three-week observational visit in a range of international healthcare settings. Findings: Similarities and differences between Australian and UK healthcare systems were observed. Models of care using a range of resources, including structured health and wellbeing programmes, were identified to support transitional care. Models of collaborative working across organisations were observed. The implementation of innovative programmes to improve efficiency of services and limit unnecessary impact on patient time and finances were identified, including the use of Skype for collaborative consultations between acute and community healthcare providers. Conclusions: Recommendations to benefit AYA patients with an improved range of supportive, holistic services and improved person-centred care include: •\tJoint AYA nursing posts between AYA centres to support transition •\tStructured AYA post-treatment health and wellbeing programme •\tProgramme of creative wellbeing projects to support transition at the end of treatment Scope use of Skype appointments within the AYA service Implications for practice: Observing service provision and healthcare practice in an international setting provides the opportunity to improve cross-cultural competence, which is essential to culturally competent care. Cross-cultural competence supports the improvement of patient care through experiential learning, sharing of ideas and connecting with others. The

  7. Performance of Different Diagnostic Criteria for Familial Mediterranean Fever in Children with Periodic Fevers : Results from a Multicenter International Registry

    NARCIS (Netherlands)

    Demirkaya, Erkan; Saglam, Celal; Turker, Turker; Koné-Paut, Isabelle; Woo, Pat; Doglio, Matteo; Amaryan, Gayane; Frenkel, Joost; Uziel, Yosef; Insalaco, Antonella; Cantarini, Luca; Hofer, Michael; Boiu, Sorina; Duzova, Ali; Modesto, Consuelo; Bryant, Annette; Rigante, Donato; Papadopoulou-Alataki, Efimia; Guillaume-Czitrom, Severine; Kuemmerle-Deschner, Jasmine; Neven, Bénédicte; Lachmann, Helen; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco; Ozen, Seza

    2015-01-01

    OBJECTIVE: Our aims were to validate the pediatric diagnostic criteria in a large international registry and to compare them with the performance of previous criteria for the diagnosis of familial Mediterranean fever (FMF). METHODS: Pediatric patients with FMF from the Eurofever registry were used

  8. In-work tax credits for families and their impact on health status in adults.

    Science.gov (United States)

    Pega, Frank; Carter, Kristie; Blakely, Tony; Lucas, Patricia J

    2013-08-06

    By improving two social determinants of health (poverty and unemployment) in low- and middle-income families on or at risk of welfare, in-work tax credit for families (IWTC) interventions could impact health status and outcomes in adults. To assess the effects of IWTCs on health outcomes in working-age adults (18 to 64 years). We searched 16 electronic academic databases, including the Cochrane Public Health Group Specialised Register, Cochrane Database of Systematic Reviews (The Cochrane Library 2012, Issue 7), MEDLINE and EMBASE, as well as six grey literature databases between July and September 2012 for records published between January 1980 and July 2012. We also searched key organisational websites, handsearched reference lists of included records and relevant journals, and contacted academic experts. We included randomised and quasi-randomised controlled trials and cohort, controlled before-and-after (CBA) and interrupted time series (ITS) studies of IWTCs in working-age adults. Included primary outcomes were: self rated general health; mental health/psychological distress; mental illness; overweight/obesity; alcohol use and tobacco use. Two review authors independently extracted data and assessed the risk of bias in included studies. We contacted study authors to obtain missing information. Five studies (one CBA and four ITS) comprising a total of 5,677,383 participants (all women) fulfilled the inclusion criteria and were synthesised narratively. The in-work tax credit intervention assessed in all included studies is the permanent Earned Income Tax Credit in the United States, established in 1975. This intervention distributed nearly USD 62 billion to over 27 million individuals in 2011, and its administration costs were less than one per cent of its total costs. All included studies carried a high risk of bias (especially from confounding and insufficient control for underlying time trends). Due to the small number of (observational) studies and their

  9. COPING AS A MEDIATOR OF INTERNALIZED HOMOPHOBIA AND PSYCHOLOGICAL DISTRESS AMONG YOUNG ADULT SEXUAL MINORITY WOMEN.

    Science.gov (United States)

    Kaysen, Debra; Kulesza, Magdalena; Balsam, Kimberly F; Rhew, Isaac C; Blayney, Jessica A; Lehavot, Keren; Hughes, Tonda L

    2014-09-01

    Sexual minorities have higher rates of depression and anxiety than their heterosexual counterparts. This elevated risk of psychological distress has generally been hypothesized to be a result of the effects of discrimination including internalized negative beliefs about sexual minorities. However, little research has examined the role of various types of coping in mediating between internalized homophobia and mental health. We tested the direct relationship between internalized homophobia and psychological distress and evaluated general and sexual minority-specific coping strategies as potential mediators using structural equation modeling. Data are from a national sample of 1,099 young adult sexual minority women who were on average 20.86 ( SD = 2.12) years old, participating in a study on mental health and substance use. The model demonstrated acceptable fit, χ 2 (83) = 402.9, p homophobia and psychological distress, sexual minority-specific coping did not. Our findings support previous studies that have demonstrated the impact of internalized homophobia on psychological distress as well as the role of coping as a protective/risk factor in this relationship.

  10. Geriatrics Curricula for Internal and Family Medicine Residents: Assessing Study Quality and Learning Outcomes.

    Science.gov (United States)

    Cheng, Huai Yong; Davis, Molly

    2017-02-01

    Prior reviews of geriatrics curricula for internal medicine (IM) and family medicine (FM) residents have not evaluated study quality or assessed learning objectives or specific IM or FM competencies. This review of geriatrics curricula for IM and FM residents seeks to answer 3 questions: (1) What types of learning outcomes were measured? (2) How were learning outcomes measured? and (3) What was the quality of the studies? We evaluated geriatrics curricula that reported learning objectives or competencies, teaching methods, and learning outcomes, and those that used a comparative design. We searched PubMed and 4 other data sets from 2003-2015, and assessed learning outcomes, outcome measures, and the quality of studies using the Medical Education Research Study Quality Instrument (MERSQI) and Best Evidence Medical Education (BEME) methods. Fourteen studies met inclusion criteria. Most curricula were intended for IM residents in the inpatient setting; only 1 was solely dedicated to FM residents. Median duration was 1 month, and minimum geriatrics competencies covered were 4. Learning outcomes ranged from Kirkpatrick levels 1 to 3. Studies that reported effect size showed a considerable impact on attitudes and knowledge, mainly via pretests and posttests. The mean MERSQI score was 10.5 (range, 8.5-13) on a scale of 5 (lowest quality) to 18 (highest quality). Few geriatrics curricula for IM and FM residents that included learning outcome assessments were published recently. Overall, changes in attitudes and knowledge were sizeable, but reporting was limited to low to moderate Kirkpatrick levels. Study quality was moderate.

  11. Familial risk for lifestyle-related chronic diseases: can family health history be used as a motivational tool to promote health behaviour in young adults?

    Science.gov (United States)

    Prichard, I; Lee, A; Hutchinson, A D; Wilson, C

    2015-08-01

    Risk for colorectal cancer, breast cancer, heart disease and diabetes has both a familial and a lifestyle component. This quasi-experimental study aimed to determine whether a Family Health History (FHH) assessment and the subsequent provision of risk information would increase young adults' (17-29 years) intentions to modify health behaviours associated with the risk of these chronic diseases (i.e. alcohol consumption, fruit and vegetable intake and physical activity) and to talk to their family about their risk. After baseline measures of current and intended health-related behaviours, participants (n = 116) were randomly allocated to either a FHH assessment or control information. Based on the FHH provided, participants in the FHH condition were then classified as 'above-average risk' or 'average risk'. One week later, participants were provided with tailored health information and completed follow-up measures of intended health-related behaviours and perceived vulnerability. Participants classified as 'above-average risk' had increased perceptions of vulnerability to a chronic disease. Despite this, no group differences were found in intentions to change physical activity or fruit and vegetable consumption. Participants with above-average risk reported greater intentions to decrease the frequency of their alcohol consumption than average risk/control participants. In addition, completing a FHH assessment promoted intended communication with family members about chronic disease risk. FHH assessments may have the greatest value within the family context. SO WHAT? Future research could examine the impact of providing FHH information to different family members as a health promotion strategy.

  12. Development of an international research agenda for adult congenital heart disease nursing.

    Science.gov (United States)

    Goossens, Eva; Fleck, Desiree; Canobbio, Mary M; Harrison, Jeanine L; Moons, Philip

    2013-02-01

    Since the population of adults with congenital heart disease (CHD) is growing, the role of nurse specialists is expanding. In order to advance ACHD nursing, the establishment of an international nursing research agenda is recommended. We aimed to investigate research priorities as perceived by nurse specialists and researchers in ACHD. We applied a sequential quan-qual design. In the quantitative phase, a two-round Delphi study was conducted, in which 37 nurse specialists and nurse researchers in ACHD care participated. Respondents assessed the level of priority of 21 research topics using a 9-point rating scale (1 = no priority at all; 9 = very high priority). In the qualitative phase, semi-structured interviews were performed with six selected Delphi panelists, to scrutinize pending research questions. This study revealed that priority should be given to studies investigating knowledge and education of patients, outcomes of Advanced Practice Nursing, quality of life, transfer and transition, and illness experiences and psychosocial issues in adults with CHD. A low priority was given to post-operative pain, sexual functioning, transplantation in ACHD, and health care costs and utilization. Agreement about the level of priority was obtained for 14 out of 21 research topics. Based on this study, we could develop an international research agenda for ACHD. Researchers ought to focus on these areas of highest priority, in order to expand and strengthen the body of knowledge in ACHD nursing.

  13. Intertemporal choice behavior in emerging adults and adults: effects of age interact with alcohol use and family history status

    Directory of Open Access Journals (Sweden)

    Christopher T. Smith

    2015-11-01

    Full Text Available Adults with alcohol use disorders (AUDs show marked immediate reward selection (or Now bias in intertemporal choice tasks. This Now bias persists long into abstinence, suggesting an irreversible consequence of chronic alcohol abuse or a pre-existing AUD intermediate phenotype. However, some data show substantial Now bias among emerging adults (18-25, regardless of drinking behavior, suggesting age-dependent effects on Now bias. The objectives of the present study were to determine 1 whether Now bias is greater among emerging adults relative to adults, 2 whether any such age effect on Now bias is diminished in sub-clinical heavy alcohol users, and 3 whether having a problem drinking first degree relative is independently associated with elevated Now bias. To achieve these objectives, we used an intertemporal choice task to quantify Now bias in n=237 healthy participants (ages 18-40; 50% female, and a wide range of non-zero alcohol use, based on the Alcohol Use Disorders Identification Test (AUDIT. We found that among non-heavy drinkers, Now bias inversely correlated with age; this relationship was not present among heavy drinkers. We found no significant relationship between AUDIT score and Now bias among emerging adults, but AUDIT scores and Now bias were positively correlated among 26-40 year olds.

  14. Reliability of the Serbian version of the International Physical Activity Questionnaire for older adults

    Directory of Open Access Journals (Sweden)

    Milanović Z

    2014-04-01

    Full Text Available Zoran Milanović,1 Saša Pantelić,1 Nebojša Trajković,1 Bojan Jorgić,1 Goran Sporiš,2 Milovan Bratić1 1Faculty of Sport and Physical Education, University of Niš, Niš, Serbia; 2Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia Abstract: The purpose of this study was to determine the test–retest reliability of the International Physical Activity Questionnaire (IPAQ for older adults in Serbia. Six hundred and sixty older adults (352 men, 53%; 308 women, 47%; mean age 67.65±5.76 years participated in the study. To examine test–retest reliability, the participants were asked to complete the IPAQ on two occasions 2 weeks apart. Moderate reliability was observed between the repeated IPAQ, with intraclass correlation coefficients ranging from 0.53 to 0.91. The least reliability was established in leisure time activity (0.53 and the most reliability in the transport domain (0.91. Men and women had similar intraclass correlation coefficients for total physical activity (0.71 versus 0.74, respectively, while the biggest difference was obtained for housework in men (0.68 and in women (0.90. Our study shows that the long version of the IPAQ is a reliable instrument for assessing physical activity levels in older adults and that it may be useful for generating internationally comparable data. Keywords: questionnaire, elderly, IPAQ, physical activity

  15. Comparing Sexuality Communication Among Offspring of Teen Parents and Adult Parents: a Different Role for Extended Family

    OpenAIRE

    Grossman, Jennifer M.; Tracy, Allison J.; Richer, Amanda M.; Erkut, Sumru

    2015-01-01

    This brief report examined teenagers’ sexuality communication with their parents and extended families. It compared who teens of early parents (those who had children when they were adolescents) and teens of later parents (those who were adults when they had children) talk to about sex. Eighth grade students (N=1281) in 24 schools completed survey items about their communication about sex. Structural equation modeling was used to predict communication profiles, while adjusting for the nesting...

  16. Sex and family history of cardiovascular disease influence heart rate variability during stress among healthy adults.

    Science.gov (United States)

    Emery, Charles F; Stoney, Catherine M; Thayer, Julian F; Williams, DeWayne; Bodine, Andrew

    2018-07-01

    Studies of sex differences in heart rate variability (HRV) typically have not accounted for the influence of family history (FH) of cardiovascular disease (CVD). This study evaluated sex differences in HRV response to speech stress among men and women (age range 30-49 years) with and without a documented FH of CVD. Participants were 77 adults (mean age = 39.8 ± 6.2 years; range: 30-49 years; 52% female) with positive FH (FH+, n = 32) and negative FH (FH-, n = 45) of CVD, verified with relatives of participants. Cardiac activity for all participants was recorded via electrocardiogram during a standardized speech stress task with three phases: 5-minute rest, 5-minute speech, and 5-minute recovery. Outcomes included time domain and frequency domain indicators of HRV and heart rate (HR) at rest and during stress. Data were analyzed with repeated measures analysis of variance, with sex and FH as between subject variables and time/phase as a within subject variable. Women exhibited higher HR than did men and greater HR reactivity in response to the speech stress. However, women also exhibited greater HRV in both the time and frequency domains. FH+ women generally exhibited elevated HRV, despite the elevated risk of CVD associated with FH+. Although women participants exhibited higher HR at rest and during stress, women (both FH+ and FH-) also exhibited elevated HRV reactivity, reflecting greater autonomic control. Thus, enhanced autonomic function observed in prior studies of HRV among women is also evident among FH+ women during a standardized stress task. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. The Association of Current Violence from Adult Family Members with Adolescent Bullying Involvement and Suicidal Feelings

    Science.gov (United States)

    Shimodera, Shinji; Koike, Shinsuke; Usami, Satoshi; Toriyama, Rie; Kanata, Sho; Sasaki, Tsukasa; Kasai, Kiyoto; Okazaki, Yuji; Nishida, Atsushi

    2016-01-01

    Although several studies have reported that child physical abuse increased the risk for bullying involvement, the effect of current violence from adult family members (CVA) on bullying involvement and suicidal feelings among adolescents has not been sufficiently examined. This study investigated the association of CVA with adolescent bullying involvement and the interaction effect of CVA and bullying involvement on suicidal feelings. This cross-sectional study used data from a school-based survey with a general population of adolescents (grades 7 to 12). Data were collected using a self-report questionnaire completed by 17,530 students. Logistic regression analyses were performed to explore the association of CVA with adolescent bullying involvement and suicidal feelings. The overall response rate was 90.2%. The odds of students being characterized as bullies, victims, and bully-victims were higher among adolescents with CVA than without CVA (odds ratios (OR) = 2.9, 95% confidence interval (CI), [2.3–3.7], 4.6 [3.6–5.8], and 5.8 [4.4–7.6], respectively). Both CVA (OR = 3.4 [95% CI 2.7–4.3]) and bullying (bullies, victims, and bully-victims; OR = 2.0 [95% CI 1.6–2.6], 4.0 [3.1–5.1], 4.1 [3.0–5.6], respectively), were associated with increased odds of current suicidal feelings after adjusting for confounding factors. Furthermore, positive additive effects of CVA and all three types of bullying involvement on suicidal feelings were found. For example, bully-victims with CVA had about 19-fold higher odds of suicidal feelings compared with uninvolved adolescents without CVA. This study, although correlational, suggested that CVA avoidance might prevent bullying involvement and suicidal feelings in adolescents. PMID:27711150

  18. The Association of Current Violence from Adult Family Members with Adolescent Bullying Involvement and Suicidal Feelings.

    Science.gov (United States)

    Fujikawa, Shinya; Ando, Shuntaro; Shimodera, Shinji; Koike, Shinsuke; Usami, Satoshi; Toriyama, Rie; Kanata, Sho; Sasaki, Tsukasa; Kasai, Kiyoto; Okazaki, Yuji; Nishida, Atsushi

    2016-01-01

    Although several studies have reported that child physical abuse increased the risk for bullying involvement, the effect of current violence from adult family members (CVA) on bullying involvement and suicidal feelings among adolescents has not been sufficiently examined. This study investigated the association of CVA with adolescent bullying involvement and the interaction effect of CVA and bullying involvement on suicidal feelings. This cross-sectional study used data from a school-based survey with a general population of adolescents (grades 7 to 12). Data were collected using a self-report questionnaire completed by 17,530 students. Logistic regression analyses were performed to explore the association of CVA with adolescent bullying involvement and suicidal feelings. The overall response rate was 90.2%. The odds of students being characterized as bullies, victims, and bully-victims were higher among adolescents with CVA than without CVA (odds ratios (OR) = 2.9, 95% confidence interval (CI), [2.3-3.7], 4.6 [3.6-5.8], and 5.8 [4.4-7.6], respectively). Both CVA (OR = 3.4 [95% CI 2.7-4.3]) and bullying (bullies, victims, and bully-victims; OR = 2.0 [95% CI 1.6-2.6], 4.0 [3.1-5.1], 4.1 [3.0-5.6], respectively), were associated with increased odds of current suicidal feelings after adjusting for confounding factors. Furthermore, positive additive effects of CVA and all three types of bullying involvement on suicidal feelings were found. For example, bully-victims with CVA had about 19-fold higher odds of suicidal feelings compared with uninvolved adolescents without CVA. This study, although correlational, suggested that CVA avoidance might prevent bullying involvement and suicidal feelings in adolescents.

  19. Factors associated with constructive staff-family relationships in the care of older adults in the institutional setting.

    Science.gov (United States)

    Haesler, Emily; Bauer, Michael; Nay, Rhonda

    2006-12-01

    Background  Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives  The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff-family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff-family relationships. Search strategy  A literature search was performed using the following databases for the years 1990-2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage

  20. Grandparent-grandchild family capital and self-rated health of older rural Chinese adults: the role of the grandparent-parent relationship.

    Science.gov (United States)

    Lou, Vivian W Q; Lu, Nan; Xu, Ling; Chi, Iris

    2013-07-01

    This study tested the relationship between grandparent-grandchild family capital and self-rated health of older rural Chinese adults and the mediating role of the grandparent-parent relationship in terms of grandparent-grandchild family capital and self-rated health. Data were derived from a random sample of 1,027 adults aged 60 and older who were interviewed in the rural Chaohu region in 2009. Structural equation modeling was used to examine the direct effect of grandparent-grandchild family capital in terms of relations with the first child's family on self-rated health among respondents, as well as the mediating effect of the grandparent-parent relationship. The results showed the direct effect of grandparent-grandchild family capital on self-rated health of older rural Chinese adults. The grandparent-parent relationship had a partial mediation effect on the relationship between grandparent-grandchild family capital and self-rated health of respondents. Grandparent-grandchild family capital had a unique direct effect on the self-rated health of older rural Chinese adults, enriching our theoretical understanding of sources of family capital and their impacts in a collectivist cultural context that emphasizes intergenerational interaction and exchange. The findings also highlighted the mediation effects of grandparent-parent relationships on the relationship between grandparent-grandchild family capital and self-rated health of older rural Chinese adults, supporting the "grandchild-as-linkage" hypothesis in understanding the social determination of self-rated health in China.

  1. Relationship between parents and their adult children: a west European typology of late-life families

    NARCIS (Netherlands)

    Dykstra, P.A.; Fokkema, C.M.

    2011-01-01

    Following Reher’s (1998) seminal paper on family ties in western Europe, the perspective that family solidarity patterns are divided between an individualistic north and a famialistic south has dominated the literature. We challenge this view and address the variability in intergenerational family

  2. Gender Role Perceptions of Mormon Women from Divorced Families: An Adult-Developmental Analysis

    Science.gov (United States)

    Lafkas, Sara McPhee

    2012-01-01

    More American families now have shifting family forms and gender role practices, but some religious faiths still subscribe to traditional family and gender roles. Following these ideals in modern society can challenge adherents. This qualitative study examined one such faith, considering the perceptions of Mormon (i.e., Latter-day Saint) women…

  3. Associations among measures of sequential processing in motor and linguistics tasks in adults with and without a family history of childhood apraxia of speech: a replication study.

    Science.gov (United States)

    Button, Le; Peter, Beate; Stoel-Gammon, Carol; Raskind, Wendy H

    2013-03-01

    The purpose of this study was to address the hypothesis that childhood apraxia of speech (CAS) is influenced by an underlying deficit in sequential processing that is also expressed in other modalities. In a sample of 21 adults from five multigenerational families, 11 with histories of various familial speech sound disorders, 3 biologically related adults from a family with familial CAS showed motor sequencing deficits in an alternating motor speech task. Compared with the other adults, these three participants showed deficits in tasks requiring high loads of sequential processing, including nonword imitation, nonword reading and spelling. Qualitative error analyses in real word and nonword imitations revealed group differences in phoneme sequencing errors. Motor sequencing ability was correlated with phoneme sequencing errors during real word and nonword imitation, reading and spelling. Correlations were characterized by extremely high scores in one family and extremely low scores in another. Results are consistent with a central deficit in sequential processing in CAS of familial origin.

  4. Worry about not having a caregiver and depressive symptoms among widowed older adults in China: the role of family support.

    Science.gov (United States)

    Xu, Ling; Li, Yawen; Min, Joohong; Chi, Iris

    2017-08-01

    Using the stress-coping framework, this study examined whether worry about not having a caregiver in old age was associated with depressive symptoms among widowed Chinese older adults, including the moderating effects of self-perceived family support. Using a sample of 5331 widowed adults aged 60 years old or older from the 2006 National Sample Survey of the Aged Population in Urban/Rural China, we regressed measures of depressive symptoms on worry about not having a caregiver. We also tested moderation effects of family support. Individuals who were worried about not having a caregiver reported significantly higher levels of depressive symptoms. Feeling that their children are filial, having instrumental support from children, and having only daughters moderated the effects of worry about not having a caregiver on depressive symptoms. Our findings indicate the detrimental effects of worry about not having a caregiver on the psychological well-being of widowed older adults. This study also highlights some forms of family support that may help reduce such negative effects of widowhood.

  5. Factors associated to the overweight in adults assisted by a family health unit

    Directory of Open Access Journals (Sweden)

    Cloud Kennedy Couto de Sá

    2008-04-01

    Full Text Available The objective of this study was to investigate the factors associated with overweight in adults and the frequencies of these factors. The sample comprised 101 adults, all aged ≥ 18 years, 75 (74.0% females and 26 (26.0% males, registered at a Family Health Center (FHC in the town of Jequié, and distributed proportionally throughout the FHC’s seven sub-areas. Patients were defined as overweight if their body mass index (BMI was ≥ 25kg/m². The proportion of overweight people was calculated for the whole sample and for each of the associated variables (age, sex, occupation, educational level, number of meals per day, smoking, alcoholism, arterial hypertension, diabetes, dyslipidemia and habitual level of physical activity. The chi-square test was applied to test associations between the variables and the proportion of overweight to a significance level of 5% (p ≤ 0.05. the overall frequency of overweight was 28.0%, and this was more prevalent only among individuals who do not consume alcoholic beverages, although the comparison between those with and without hypertension was borderline (p = 0.052. The results of this study suggest a need for further investigation into the effect of alcoholic beverages on the nutritional status of adults and for implementation of nutritional vigilance strategies at this FHC, with special attention given to hypertense patients. Resumo ResumoO objetivo do estudo foi verificar a freqüência e fatores associados ao sobrepeso em adultos acompanhados por uma Unidade de Saúde da Família (USF, na cidade de Jequié, Bahia, Brasil. O desenho foi transversal em amostra de 101 adultos ≥ 18 anos de idade, cadastrados e distribuídos proporcionalmente entre as sete microáreas da USF, sendo 75 (74,0% do sexo feminino e 26 (26,0% do masculino. Com sobrepeso foram considerados aqueles que apresentaram índice de massa corporal (IMC ≥ 25kg/m². Calculou-se a freqüência do sobrepeso no total e por vari

  6. Factors associated with young adults' knowledge regarding family history of Stroke.

    Science.gov (United States)

    Lima, Maria Jose Melo Ramos; Moreira, Thereza Maria Magalhães; Florêncio, Raquel Sampaio; Braga, Predro

    2016-11-21

    to analyze the factors associated with young adults' knowledge regarding family history of stroke. an analytical transversal study, with 579 young adults from state schools, with collection of sociodemographic, clinical and risk factor-related variables, analyzed using logistic regression (backward elimination). a statistical association was detected between age, civil status, and classification of arterial blood pressure and abdominal circumference with knowledge of family history of stroke. In the final logistic regression model, a statistical association was observed between knowledge regarding family history of stroke and the civil status of having a partner (ORa=1.61[1.07-2.42]; p=0.023), abdominal circumference (ORa=0.98[0.96-0.99]; p=0.012) and normal arterial blood pressure (ORa=2.56[1.19-5.52]; p=0.016). an association was observed between socioeconomic factors and risk factors for stroke and knowledge of family history of stroke, suggesting the need for health education or even educational programs on this topic for the clientele in question. analisar os fatores associados ao conhecimento dos adultos jovens sobre histórico familiar de Acidente Vascular Cerebral (AVC). estudo transversal analítico, com 579 adultos jovens de escolas públicas, com coleta de variáveis sociodemográficas, clínicas e de fatores de risco em formulário, analisados utilizando-se regressão logística (backward elimination). detectou-se associação estatística de idade, situação conjugal, classificação da pressão arterial e circunferência abdominal com conhecimento do histórico familiar de AVC. No modelo final de regressão logística, observou-se associação estatística do conhecimento sobre histórico familiar de AVC com situação conjugal com companheiro (ORa=1,61[1,07-2,42]; p=0,023), circunferência abdominal (ORa=0,98[0,96-0,99]; p=0,012) e pressão arterial normal (ORa=2,56[1,19-5,52]; p=0,016). foi constatada associação de fatores socioeconômicos e de

  7. Family stressors, home demands and responsibilities, coping resources, social connectedness, and Thai older adult health problems: examining gender variations.

    Science.gov (United States)

    Krishnakumar, Ambika; Narine, Lutchmie; Soonthorndhada, Amara; Thianlai, Kanchana

    2015-03-01

    To examine gender variations in the linkages among family stressors, home demands and responsibilities, coping resources, social connectedness, and older adult health problems. Data were collected from 3,800 elderly participants (1,654 men and 2,146 women) residing in Kanchanaburi province, Thailand. Findings indicated gender variations in the levels of these constructs and in the mediational pathways. Thai women indicated greater health problems than men. Emotional empathy was the central variable that linked financial strain, home demands and responsibilities, and older adult health problems through social connectedness. Financial strain (and negative life events for women) was associated with lowered coping self-efficacy and increased health problems. The model indicated greater strength in predicting female health problems. Findings support gender variations in the relationships between ecological factors and older adult health problems. © The Author(s) 2014.

  8. Family poverty over the early life course and recurrent adolescent and young adult anxiety and depression: a longitudinal study.

    Science.gov (United States)

    Najman, Jake M; Hayatbakhsh, Mohammad R; Clavarino, Alexandra; Bor, William; O'Callaghan, Michael J; Williams, Gail M

    2010-09-01

    We determined whether exposure to family poverty over a child's early life course predicts adolescent and young adult anxiety and depression. We used a birth cohort study of a sample of women in Brisbane, Australia, who were recruited in early pregnancy and whose children were followed up on at ages 14 and 21 years. Some 2609 mothers and adolescents provided usable data at the 14- and 21-year follow-ups. After adjustment for poverty at other phases, poverty at the 14-year follow-up was the strongest predictor of adolescent and young adult anxiety and depression. The more frequently the child was exposed to poverty, the greater was the risk of that individual being anxious and depressed at both the 14- and 21-year follow-ups. Family poverty predicts higher rates of adolescent and young adult anxiety and depression. Increased frequency of child exposure to poverty is a consistent predictor of adolescent and young adult anxiety and depression. Repeated experiences of poverty over a child's early life course are associated with increased levels of poor mental health.

  9. Parental Divorce and Family History of Alcohol Disorder: Associations with Young Adults' Alcohol Problems, Marijuana Use, and Interpersonal Relations.

    Science.gov (United States)

    Windle, Michael; Windle, Rebecca C

    2018-06-01

    This study used prospective data from 706 young adults to evaluate the impact of parental divorce and family history of alcoholism (FH+) on the outcomes of offspring alcohol problems, marijuana use, and interpersonal relationships with parents. Assessments of parental divorce were based on parent reports, and young adult outcomes were collected from an offspring cohort (n = 706; X age = 33.25 years; females = 53%) via computer-based individual interviews (CAPI and ACASI). Family history of alcohol disorders for parents was based on assessments by mothers, fathers, and young adults. Parental divorce significantly predicted marijuana use but not alcohol problems. Maternal, but not paternal, alcoholism also significantly predicted marijuana use. Two-way interactions indicated that sex moderated several of the relationships. For example, among those with divorced parents, daughters reported higher levels of conflict with fathers than sons, and sons reported lower levels of maternal support than daughters. Paternal alcoholism was also associated with higher levels of alcohol problems among sons relative to daughters. There was also a significant 2-way interaction between divorce status and maternal alcoholism indicating that young adults who experienced both maternal alcoholism and parental divorce had the highest levels of marijuana use. These findings highlight the role that parental divorce and FH+ have on alcohol problems, marijuana use, and interpersonal relationships in young adulthood, and how sex may moderate some of these more nuanced relationships. Copyright © 2018 by the Research Society on Alcoholism.

  10. Parenting stress in mothers of adults with an intellectual disability: parental cognitions in relation to child characteristics and family support.

    Science.gov (United States)

    Hill, C; Rose, J

    2009-12-01

    There is a body of evidence that indicates that the cognitions of parents of children with intellectual disabilities (ID) play an important role in influencing parental stress. However, there is a paucity of evidence about the experience of parents of adult children with ID. This study sought to apply a model of parenting stress to mothers of adults with ID. Of particular interest were the parental cognitions of parenting self-esteem and parental locus of control. Face-to face interviews were administered with 44 mothers of adults with ID. They completed the Vineland Adaptive and Maladaptive Behaviour Scale, the Family Support Scale, the Parenting Sense of Competence Scale, a shortened version of the Parental Locus of Control Scale and the Parenting Stress Index. Correlations were observed between parenting stress and the other study variables. Regression analysis revealed that parental cognitive variables predicted 61% of the variance in parenting stress. Parenting satisfaction, a subscale of the measure of parenting sense of competence, mediated the relationships between adaptive behaviour and parenting stress and between family support and parenting stress. These results indicate the importance of cognitive variables in the stress of mothers of adults with ID. Potential avenues of future research might focus on the experience of fathers and the impact of positive perceptions as a cognitive factor.

  11. Reflective practice and social responsibility in family medicine: Effect of performing an international rotation in a developing country.

    Science.gov (United States)

    Loignon, Christine; Gottin, Thomas; Valois, Carol; Couturier, François; Williams, Robert; Roy, Pierre-Michel

    2016-11-01

    To explore the perceived effect of an elective international health rotation on family medicine resident learning. Qualitative, collaborative study based on semistructured interviews. Quebec. A sample of 12 family medicine residents and 9 rotation supervisors (N = 21). Semistructured interviews of residents and rotation supervisors. Residents and supervisors alike reported that their technical skills and relationship skills had benefited. All increased their knowledge of tropical pathologies and learned to expand their clinical examinations. They benefited from having very rich interactions in other care settings, working with vulnerable populations. The rotations had their greatest effect on relationship skills (communication, empathy, etc) and the ability to work with vulnerable patients. All of the participants were exposed to local therapies and local interpretations of disease symptoms and pathogenesis. The findings of this study will have a considerable effect on pedagogy. The residents' experiences of their international health rotations and what they learned in terms of medical skills and pedagogic approaches in working with patients are described. Using a collaborative approach with the rotation supervisors, the data were triangulated and the benefits of an international rotation on academic training were more accurately defined. The findings can now be used to enrich academic programs in social and preventive medicine and more adequately prepare future family physicians for work in various social and cultural settings. Copyright© the College of Family Physicians of Canada.

  12. Differential cytotoxicity and internalization of graphene family nanomaterials in myocardial cells

    Energy Technology Data Exchange (ETDEWEB)

    Contreras-Torres, Flavio F., E-mail: contreras.flavio@itesm.mx [Laboratorio de Nanotecnología Ambiental, Centro del Agua para América Latina y el Caribe, Tecnológico de Monterrey, Monterrey, 64849 (Mexico); Rodríguez-Galván, Andrés [Department of Chemistry, Universityof Oxford, South Parks Road, Oxford OX1 3QZ (United Kingdom); Guerrero-Beltrán, Carlos E. [Cátedra de Cardiología y Medicina Vascular, Escuela Nacional de Medicina, Tecnológico de Monterrey, Monterrey, 64849 (Mexico); Martínez-Lorán, Erick [Department of NanoEngineering, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093 (United States); Vázquez-Garza, Eduardo [Cátedra de Cardiología y Medicina Vascular, Escuela Nacional de Medicina, Tecnológico de Monterrey, Monterrey, 64849 (Mexico); Ornelas-Soto, Nancy [Laboratorio de Nanotecnología Ambiental, Centro del Agua para América Latina y el Caribe, Tecnológico de Monterrey, Monterrey, 64849 (Mexico); and others

    2017-04-01

    Given the well-known physical properties of graphene oxide (GO), numerous applications for this novel nanomaterial have been recently envisioned to improve the performance of biomedical devices. However, the toxicological assessment of GO, which strongly depends on the used material and the studied cell line, is a fundamental task that needs to be performed prior to its use in biomedical applications. Therefore, the toxicological characterization of GO is still ongoing. This study contributes to this, aiming to synthesize and characterize GO particles and thus investigate their toxic effects in myocardial cells. Herein, GO particles were produced from graphite using the Tour method and subsequent mild reduction was carried out to obtain low-reduced GO (LRGO) particles. A qualitative analysis of the viability, cellular uptake, and internalization of particles was carried out using GO (~ 54% content of oxygen) and LRGO (~ 37% content of oxygen) and graphite. GO and LRGO reduce the viability of cardiac cells at IC{sub 50} of 652.1 ± 1.2 and 129.4 ± 1.2 μg/mL, respectively. This shows that LRGO particles produce a five-fold increase in cytotoxicity when compared to GO. The cell uptake pattern of GO and LRGO particles demonstrated that cardiac cells retain a similar complexity to control cells. Morphological alterations examined with electron microscopy showed that internalization by GO and LRGO-treated cells (100 μg/mL) occurred affecting the cell structure. These results suggest that the viability of H9c2 cells can be associated with the surface chemistry of GO and LRGO, as defined by the amount of oxygen functionalities, the number of graphitic domains, and the size of particles. High angle annular dark-field scanning transmission electron microscopy, dynamic light-scattering, Fourier-transform infrared, Raman, and X-ray photoelectron spectroscopies were used to characterize the as-prepared materials. - Highlights: • H9c2 cells were treated with a family of

  13. [Primary immune thrombocytopenia in adults in Mexico: national characteristics and the relation to international literature].

    Science.gov (United States)

    Meillón-García, Luis Antonio; García-Chávez, Jaime; Gómez-Almaguer, David; Gutiérrez-Espíndola, Guillermo R; Martínez-Murillo, Carlos

    2014-01-01

    In order to identify the clinical approach of a sample of Mexican hematologists for primary immune thrombocytopenia (ITP) in adults in Mexico, we applied an electronic survey via the internet to identify common practices for the diagnosis and treatment of ITP and draw a comparison between the information from these hematologists with international guidelines or the international literature. The results were analyzed using measures of central tendency. The sample was 21 medical hematologists, predominantly from Mexico City (average age: 51.4 years). A total of 66.7% of the surveyed physicians use international guidelines to make therapeutic decisions, and 43% defined ITP including the numerical concept (< 100 x 10(9)/l). We found some differences between requested clinical exams and tests indicated by the guidelines. In first-line treatment (except emergency), 91% of the participants start with prednisone and 24% use dexamethasone. Danazol is used in persistent ITP by most (41%) of the specialists. In second-line treatment, 67% would indicate splenectomy. Some differences were found between clinical practice of the hematologists in Mexico versus guidelines recommendations.

  14. Family members' informal roles in end-of-life decision making in adult intensive care units.

    Science.gov (United States)

    Quinn, Jill R; Schmitt, Madeline; Baggs, Judith Gedney; Norton, Sally A; Dombeck, Mary T; Sellers, Craig R

    2012-01-01

    To support the process of effective family decision making, it is important to recognize and understand informal roles that various family members may play in the end-of-life decision-making process. To describe some informal roles consistently enacted by family members involved in the process of end-of-life decision making in intensive care units. Ethnographic study. Data were collected via participant observation with field notes and semistructured interviews on 4 intensive care units in an academic health center in the mid-Atlantic United States from 2001 to 2004. The units studied were a medical, a surgical, a burn and trauma, and a cardiovascular intensive care unit. Health care clinicians, patients, and family members. Informal roles for family members consistently observed were primary caregiver, primary decision maker, family spokesperson, out-of-towner, patient's wishes expert, protector, vulnerable member, and health care expert. The identified informal roles were part of families' decision-making processes, and each role was part of a potentially complicated family dynamic for end-of-life decision making within the family system and between the family and health care domains. These informal roles reflect the diverse responses to demands for family decision making in what is usually a novel and stressful situation. Identification and description of these informal roles of family members can help clinicians recognize and understand the functions of these roles in families' decision making at the end of life and guide development of strategies to support and facilitate increased effectiveness of family discussions and decision-making processes.

  15. Teaching cardiac auscultation to trainees in internal medicine and family practice: Does it work?

    Science.gov (United States)

    Favrat, B; Pécoud, A; Jaussi, A

    2004-01-01

    Background The general proficiency in physical diagnostic skills seems to be declining in relation to the development of new technologies. The few studies that have examined this question have invariably used recordings of cardiac events obtained from patients. However, this type of evaluation may not correlate particularly well with bedside skills. Our objectives were 1) To compare the cardiac auscultatory skills of physicians in training with those of experienced cardiologists by using real patients to test bedside diagnostic skills. 2) To evaluate the impact of a five-month bedside cardiac auscultation training program. Methods 1) In an academic primary care center, 20 physicians (trainees in internal medicine and family practice) and two skilled academic cardiologists listened to 33 cardiac events in 13 patients directly at bedside and identified the cardiac events by completing an open questionnaire. Heart sounds, murmurs and diagnosis were determined beforehand by an independent skilled cardiologist and were validated by echocardiography. Thirteen primary cardiologic diagnoses were possible. 2) Ten of the physicians agreed to participate in a course of 45-minute sessions once a week for 5 months. After the course they listened again to the same patients (pre/post-interventional study). Results 1) The experts were the most skillful, achieving 69% recognition of heart sounds and murmurs and correct diagnoses in 62% of cases. They also heard all of the diastolic murmurs. The residents heard only 40% of the extra heart sounds and made a correct diagnosis in 24% of cases. 2) After the weekly training sessions, their mean percentage for correct diagnosis was 35% [an increase of 66% (p < 0.05)]. Conclusions The level of bedside diagnostic skills in this relatively small group of physicians in training is indeed low, but can be improved by a course focusing on realistic bedside teaching. PMID:15056393

  16. Parental Endorsement of Spanking and Children’s Internalizing and Externalizing Problems in African American and Hispanic Families

    Science.gov (United States)

    Coley, Rebekah Levine; Kull, Melissa A.; Carrano, Jennifer

    2014-01-01

    This study assessed prospective, bidirectional associations between maternal endorsement of spanking and children’s internalizing and externalizing behavior problems in low-income urban African American and Hispanic (N = 592) families drawn from the Three City Study. Children in sample families were followed from early childhood through middle childhood with three sets of interviews and assessments at ages 3, 4, and 9 years. Cross-lagged path analyses tested longitudinal bidirectional associations between parental endorsement of spanking and children’s internalizing and externalizing problems, with multi-group comparisons employed to test group differences between race/ethnic groups. African American and Hispanic mothers showed similar endorsements of spanking. Results suggest that associations between spanking endorsement and child functioning were due primarily to parenting effects, with spanking predicting changes in children’s behaviors, rather than child evocative effects, with limited evidence of child behaviors predicting changes in parental spanking. Maternal spanking endorsement predicted short-term decreases in children’s internalizing problems in early childhood, but over the longer term spanking was associated with increased internalizing and externalizing problems for both African American and Hispanic children in middle childhood among economically disadvantaged families. PMID:24364363

  17. International definition of a point-of-care test in family practice: a modified e-Delphi procedure.

    Science.gov (United States)

    Schols, Angel M R; Dinant, Geert-Jan; Hopstaken, Rogier; Price, Christopher P; Kusters, Ron; Cals, Jochen W L

    2018-01-29

    The use of point-of-care tests (POCTs) in family practice is increasing, and the term POCT is often used in medical literature and clinical practice. Yet, no widely supported definition by several professional fields exists. To reach consensus on an international definition of a POCT in family practice. We performed a modified international e-Delphi procedure of four rounds among expert panel members from different professional backgrounds-family practitioners, laboratory specialists, policymakers, researchers and manufacturers. Of 27 panel members from seven different countries, 26 participated in all rounds. Most panel members were active in POCT research or policymaking and 70% worked in family medicine. After choosing important components, structuring of answers and feedback, the following definition was chosen as the best or second best definition by 81% of panel members: a point-of-care test in family practice is a test to support clinical decision making, which is performed by a qualified member of the practice staff nearby the patient and on any part of the patient's body or its derivatives, during or very close to the time of consultation, to help the patient and physician to decide upon the best suited approach, and of which the results should be known at the time of the clinical decision making. The definition emerging from this study can inform family practitioners, laboratory specialists, policymakers and manufacturers on the most widely supported and recognized definition and could act as a clear starting point for the organization and execution of professional point-of-care testing in family practice worldwide. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. The Roles of Family and Teacher Support in Moderating and Mediating Externalized and Internalized Outcomes of Exposure to Community Violence Among Arab and Jewish Adolescents in Israel.

    Science.gov (United States)

    Haj-Yahia, Muhammad M; Leshem, Becky; Guterman, Neil B

    2018-02-01

    The study examined family and teacher support as factors that can protect adolescents from internalized and externalized problems after exposure to community violence (ECV). Self-administered questionnaires were filled out by a sample of 1,832 Arab and Jewish Israeli high school students. The Arab adolescents reported significantly higher levels of community violence victimization, internalized problems, externalized problems, family support, and teacher support than the Jewish adolescents. The girls reported higher levels of internalized problems, and the boys reported higher levels of externalized problems. ECV predicted high levels of internalized and externalized problems, family support predicted low levels of internalized and externalized problems, and teacher support had no predictive role. Path analysis confirmed the significance of the relationships between ECV effects, support variables, and gender. The limitations of the study and implications of the findings for future research and for the development of family care and family intervention programs are discussed.

  19. Satisfaction with the relationship from the perspectives of family caregivers, older adults and their home care workers.

    Science.gov (United States)

    Ayalon, Liat; Roziner, Ilan

    2016-01-01

    Given the increasing reliance on both formal (paid) and informal (unpaid) assistance for the care of older adults and the close relationships which are often formed with home care workers, the present study evaluated satisfaction with the relationship from the perspectives of the three members that make up the home caregiving triad: older adults, their family members and their home care workers. We relied on a representative sample of 223 complete caregiving triads composed of an older adult, a family member and a home care worker. Each of the members rated his or her level of satisfaction with all other members in the unit, using a seven-item self-report satisfaction with the relationship scale (e.g., satisfaction with communication, intimacy). The Social Relations Model (SRM) was used to partial out the specific variance associated with each of the members as either an actor (i.e., the average satisfaction as a rater, unrelated to whom the person rates) or a partner (i.e., the unique satisfaction level elicited by a person, which is consistent across all ratings of this person). The structural equations model yielded acceptable results: χ²(3) = 6.94, p = .07. Our analysis revealed that the variability associated with the worker as partner was significantly greater than the variability associated with the older adult as partner (∆χ² [1] = 9.21, p = .002) or with the family member as partner (∆χ² [1] = 8.46, p = .004). The study highlights the importance of studying satisfaction with the relationship in the home care setting and calls for further examination of the entire caregiving triad. The home care worker plays a key role in ensuring the overall satisfaction in the caregiving triad.

  20. Childhood family disruption and adult height: is there a mediating role of puberty?

    OpenAIRE

    Sheppard, P; Garcia, JR; Sear, R

    2015-01-01

    BACKGROUND AND OBJECTIVES: Childhood family background is known to be associated with child growth and development, including the onset of puberty, but less is known about the influence of childhood family disruption on outcomes in later life. Given the associations between early family disruption and childhood development, we predicted that there may be long-term health-relevant consequences of childhood disruption. METHODOLOGY: Using data from a large U.S. interview sample (n=16,207), we te...

  1. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel.

    Science.gov (United States)

    Döhner, Hartmut; Estey, Elihu; Grimwade, David; Amadori, Sergio; Appelbaum, Frederick R; Büchner, Thomas; Dombret, Hervé; Ebert, Benjamin L; Fenaux, Pierre; Larson, Richard A; Levine, Ross L; Lo-Coco, Francesco; Naoe, Tomoki; Niederwieser, Dietger; Ossenkoppele, Gert J; Sanz, Miguel; Sierra, Jorge; Tallman, Martin S; Tien, Hwei-Fang; Wei, Andrew H; Löwenberg, Bob; Bloomfield, Clara D

    2017-01-26

    The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease. © 2017 by The American Society of Hematology.

  2. Family Rejection as a Predictor of Suicide Attempts and Substance Misuse Among Transgender and Gender Nonconforming Adults.

    Science.gov (United States)

    Klein, Augustus; Golub, Sarit A

    2016-06-01

    We examined associations between family rejection and risk of suicide attempts and substance misuse among a national sample of transgender and gender nonconforming adults. Data were drawn from the National Transgender Discrimination Survey (N = 6456). This secondary analysis was restricted to 3458 individuals who self-identified as transgender or gender nonconforming and provided complete data on study variables. We used multivariable logistic regression to examine health risks by level of reported family rejection (low/moderate/high), controlling for relevant sociodemographic characteristics. Overall, 42.3% of the sample reported a suicide attempt and 26.3% reported misusing drugs or alcohol to cope with transgender-related discrimination. After controlling for age, race/ethnicity, sex assigned at birth, binary gender identity, income, education, and employment status, family rejection was associated with increased odds of both behaviors. Odds increased significantly with increasing levels of family rejection. Family rejection related to gender identity is an understudied interpersonal stressor that may negatively affect health outcomes for transgender and gender nonconforming individuals. A better understanding of the role of close relationships in both risk and resilience for transgender individuals is critical in the development of effective public health interventions for this community.

  3. Protective Factors Against the Impact of School Bullying Perpetration and Victimization on Young Adult Externalizing and Internalizing Problems

    OpenAIRE

    Hemphill, Sheryl A.; Tollit, Michelle; Herrenkohl, Todd I.

    2014-01-01

    School-based bullying perpetration and victimization is common worldwide and has profound impacts on student behavior and mental health. However, few studies have examined young adult outcomes of bullying perpetration or victimization. Research on factors that protect students who have bullied or been bullied is also lacking. This study examined young adult externalizing and internalizing problems (aged 18-19 years) and adolescent protective factors related to self-reported bullying perpetrat...

  4. An international ecological study of adult height in relation to cancer incidence for 24 anatomical sites.

    Science.gov (United States)

    Jiang, Yannan; Marshall, Roger J; Walpole, Sarah C; Prieto-Merino, David; Liu, Dong-Xu; Perry, Jo K

    2015-03-01

    Anthropometric indices associated with childhood growth and height attained in adulthood, have been associated with an increased incidence of certain malignancies. To evaluate the cancer-height relationship, we carried out a study using international data, comparing various cancer rates with average adult height of women and men in different countries. An ecological analysis of the relationship between country-specific cancer incidence rates and average adult height was conducted for twenty-four anatomical cancer sites. Age-standardized rates were obtained from GLOBOCAN 2008. Average female (112 countries) and male (65 countries) heights were sourced and compiled primarily from national health surveys. Graphical and weighted regression analysis was conducted, taking into account BMI and controlling for the random effect of global regions. A significant positive association between a country's average adult height and the country's overall cancer rate was observed in both men and women. Site-specific cancer incidence for females was positively associated with height for most cancers: lung, kidney, colorectum, bladder, melanoma, brain and nervous system, breast, non-Hodgkin lymphoma, multiple myeloma, corpus uteri, ovary, and leukemia. A significant negative association was observed with cancer of the cervix uteri. In males, site-specific cancer incidence was positively associated with height for cancers of the brain and nervous system, kidney, colorectum, non-Hodgkin lymphoma, multiple myeloma, prostate, testicular, lip and oral cavity, and melanoma. Incidence of cancer was associated with tallness in the majority of anatomical/cancer sites investigated. The underlying biological mechanisms are unclear, but may include nutrition and early-life exposure to hormones, and may differ by anatomical site.

  5. National Law Restrictions on Family Reunification Rights of International Protection Beneficiaries from a ECHR/EU Perspective

    DEFF Research Database (Denmark)

    Storgaard, Louise Halleskov

    n light of the refugee crisis, European countries are exploring new ways to restrict access of migrants to their territory. One such restriction relates to family reunification rights of international protection beneficiaries. Proposals in this area have already been adopted or are currently being...... considered in countries such as Norway, Denmark, Sweden, Austria and Germany most commonly in the form of waiting periods before applications for family reunification can be submitted and/or age requirements. The personal scope of these proposals differs. In some countries the restrictions apply/are intended...... to apply to international beneficiaries in general while they in other countries are applicable/envisaged applicable only to persons with subsidiary protection status or persons fleeing from generalised violence. The intention of the paper is to examine whether this legislative trend is in conformity...

  6. Program Experiences of Adults with Autism, Their Families, and Providers: Findings from a Focus Group Study

    Science.gov (United States)

    Koffer Miller, Kaitlin H.; Mathew, Mary; Nonnemacher, Stacy L.; Shea, Lindsay L.

    2018-01-01

    A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum…

  7. Relationships between parents and their adult children: A West European typology of late-life families

    NARCIS (Netherlands)

    P.A. Dykstra (Pearl); T. Fokkema (Tineke)

    2011-01-01

    textabstractFollowing Reher’s (1998) seminal paper on family ties in western Europe, the perspective that family solidarity patterns are divided between an individualistic north and a famialistic south has dominated the literature. We challenge this view and address the variability in

  8. Relationships between parents and their adult children: a West European typology of late-life families

    NARCIS (Netherlands)

    P.A. Dykstra (Pearl); T. Fokkema (Tineke)

    2010-01-01

    textabstractFollowing Reher’s (1998) seminal paper on family ties in western Europe, the perspective that family solidarity patterns are divided between an individualistic north and a famialistic south has dominated the literature. We challenge this view and address the variability in

  9. Ties between parents and their adult children: a Western European typology of late-life families

    NARCIS (Netherlands)

    Dykstra, P.A.; Fokkema, C.M.

    2011-01-01

    Following Reher’s (1998) seminal paper on family ties in western Europe, the perspective that family solidarity patterns are divided along the lines of an individualistic north and a familialistic south has dominated the research literature. We challenge this view and address variability in

  10. Training of Family Planning Counselors in Jordan: Developing Human Resources through Adult Education

    Science.gov (United States)

    Jabbar, Sinaria Kamil Abdel

    2012-01-01

    This paper briefly describes the development and status of family planning (FP) services, including counseling, in the Hashemite Kingdom of Jordan. It also reports extensively on a FP counseling training course organized by the Jordanian Association for Family Planning and Protection (JAFPP) which is a local NGO. A field survey approach, with…

  11. Family, welfare state generosity and the vulnerability of older adults : A cross-national study

    NARCIS (Netherlands)

    Moor, J.A.; de Graaf, P.M.; Komter, A.

    2013-01-01

    The availability of family can be considered a protective factor for aging well. In this article, we examine to what extent the family situation of older people creates vulnerability with respect to their quality of life. Because not everyone is vulnerable to the same degree, we try to identify the

  12. Stakeholder Perspectives on Policies to Support Family Caregivers of Older Adults with Dementia

    Science.gov (United States)

    Putnam, Michelle; Pickard, Joseph G.; Rodriguez, Carroll; Shear, Erin

    2010-01-01

    Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to…

  13. Internalization Mediation towards the Relationship between Entrepreneurial Action and Individual Performance for the Next Generation of Family Companies in Surabaya

    Directory of Open Access Journals (Sweden)

    Carolina Novi Mustikarini

    2017-06-01

    Full Text Available This study  examined the effect of entrepreneurial action for the performance of the next generation using the sample of students who joined the Family Business Community. In this study, there is a high contribution given by the role of entrepreneurship education in preparing the next generation in the family business. In addition, entrepreneurship education is considered possible through the process of internalization of the leaning process that is going on. For example, it is noted that entrepreneurial action can have a significant effect on the performance of the organization. In the context of the family business and entrepreneurial education at the University of Ciputra, both variables (entrepreneurial action and individual performance are necessary to be tested and therefore, the researcher finds it possible to cary out a research that is supposed to have a contribution to the family business. This study uses a hierarchical regression analysis, to test the stages of the mediation process. The results showed that most of relationships mediate internalization Entrepreneurial Action and Individual Performance.

  14. A Diagnosis of Denial: How Mental Health Classification Systems Have Struggled to Recognise Family Violence as a Serious Risk Factor in the Development of Mental Health Issues for Infants, Children, Adolescents and Adults.

    Science.gov (United States)

    Bunston, Wendy; Franich-Ray, Candice; Tatlow, Sara

    2017-10-17

    Child and adolescent mental health services (CAMHS) routinely overlook assessing for, and providing treatment to, infants and children living with family violence, despite family violence being declared endemic across the globe. As contemporary neuro-developmental research recognises the harm of being exposed to early relational trauma, key international diagnostic texts such as the DSM-5 and ICD-10 struggle to acknowledge or appreciate the relational complexities inherent in addressing family violence and its impacts during childhood. These key texts directly influence thinking, funding and research imperatives in adult services as well as CAMHS, however, they rarely reference family violence. Their emphasis is to pathologise conditions over exploring causality which may be attributable to relational violence. Consequently, CAMHS can miss important indicators of family violence, misdiagnose disorders and unwittingly, not address unacceptable risks in the child's caregiving environment. Notwithstanding urgent safety concerns, ongoing exposure to family violence significantly heightens the development of mental illness amongst children. CAMHS providers cannot and should not rely on current diagnostic manuals alone. They need to act now to see family violence as a significant and important risk factor to mental health and to treat its impacts on children before these develop into enduring neurological difficulties.

  15. A Diagnosis of Denial: How Mental Health Classification Systems Have Struggled to Recognise Family Violence as a Serious Risk Factor in the Development of Mental Health Issues for Infants, Children, Adolescents and Adults

    Directory of Open Access Journals (Sweden)

    Wendy Bunston

    2017-10-01

    Full Text Available Child and adolescent mental health services (CAMHS routinely overlook assessing for, and providing treatment to, infants and children living with family violence, despite family violence being declared endemic across the globe. As contemporary neuro-developmental research recognises the harm of being exposed to early relational trauma, key international diagnostic texts such as the DSM-5 and ICD-10 struggle to acknowledge or appreciate the relational complexities inherent in addressing family violence and its impacts during childhood. These key texts directly influence thinking, funding and research imperatives in adult services as well as CAMHS, however, they rarely reference family violence. Their emphasis is to pathologise conditions over exploring causality which may be attributable to relational violence. Consequently, CAMHS can miss important indicators of family violence, misdiagnose disorders and unwittingly, not address unacceptable risks in the child’s caregiving environment. Notwithstanding urgent safety concerns, ongoing exposure to family violence significantly heightens the development of mental illness amongst children. CAMHS providers cannot and should not rely on current diagnostic manuals alone. They need to act now to see family violence as a significant and important risk factor to mental health and to treat its impacts on children before these develop into enduring neurological difficulties.

  16. The Content and Quality of Health Information on the Internet for Patients and Families on Adult Kidney Cancer.

    Science.gov (United States)

    Alsaiari, Ahmed; Joury, Abdulaziz; Aljuaid, Mossab; Wazzan, Mohammed; Pines, Jesse M

    2017-12-01

    The Internet is one of the major sources for health information for patients and their families, particularly when patients face serious life-threatening conditions such as kidney cancer in adults. In this study, we evaluate the content and quality of health information on adult kidney cancer using several validated instruments. We accessed the three most popular search engines (Google, Yahoo, Bing), using two terms: "kidney cancer" and "renal cell carcinoma," and reviewed the top 30 hits. After exclusion of duplicated websites, websites targeting health care professionals, and unrelated websites, 35 websites were included. Content was assessed using a 22-item checklist adapted from the American Cancer Society. We assessed website quality using the DISCERN questionnaire, HONcode and JAMA benchmark criteria, readability using three readability scores, and ALEXA for global traffic ranking systems. The average website had 16 of 22 content items while 6 websites fulfilled all 22 items. Among all websites, the average DISCERN quality score was 42 out of 80, 15 (42.8 %) of websites had HONcode certification, and only 3 (8.5 %) fulfilled all JAMA benchmark criteria. The average website readability was at the ninth grade reading level. The content and quality of health-related information on the Internet for adult kidney cancer are variable in comprehensiveness and quality. Many websites are difficult to read without a high school education. A standardized approach to presenting cancer information on the Internet for patients and families may be warranted.

  17. Caregiving Practice Patterns of Asian, Hispanic, and Non-Hispanic White American Family Caregivers of Older Adults Across Generations.

    Science.gov (United States)

    Miyawaki, Christina E

    2016-03-01

    This study is a cross-sectional investigation of caregiving practice patterns among Asian, Hispanic and non-Hispanic White American family caregivers of older adults across three immigrant generations. The 2009 California Health Interview Survey (CHIS) dataset was used, and 591 Asian, 989 Hispanic and 6537 non-Hispanic White American caregivers of older adults were selected. First, descriptive analyses of caregivers' characteristics, caregiving situations and practice patterns were examined by racial/ethnic groups and immigrant generations. Practice patterns measured were respite care use, hours and length of caregiving. Three hypotheses on caregiving patterns based on assimilation theory were tested and analyzed using logistic regression and generalized linear models by racial/ethnic groups and generations. Caregiving patterns of non-Hispanic White caregivers supported all three hypotheses regarding respite care use, caregiving hours and caregiving duration, showing less caregiving involvement in later generations. However, Asian and Hispanic counterparts showed mixed results. Third generation Asian and Hispanic caregivers used respite care the least and spent the most caregiving hours per week and had the longest caregiving duration compared to earlier generations. These caregiving patterns revealed underlying cultural values related to filial responsibility, even among later generations of caregivers of color. Findings suggest the importance of considering the cultural values of each racial/ethnic group regardless of generation when working with racially and ethnically diverse populations of family caregivers of older adults.

  18. Costs of treatment of adult patients with cystic fibrosis in Poland and internationally.

    Science.gov (United States)

    Kopciuch, Dorota; Zaprutko, Tomasz; Paczkowska, Anna; Nowakowska, Elżbieta

    2017-07-01

    Despite its low prevalence, cystic fibrosis (CF) may have a considerable impact on healthcare system expenditures in terms of direct healthcare costs and lost productivity. This study was aimed at calculation of costs associated with CF treatment in Poland, as well as at comparison of average costs of treatment of CF patients in selected countries, taking into account the purchasing power parity. Retrospective study. The researchers undertook a retrospective study of adult patients with CF taking into account the broadest social perspective possible. Medical and non-medical direct costs as well as indirect costs were calculated. CF costs estimated by researchers from other countries over the last 15 years were also compared. Total annual treatment cost per one CF patient in Poland was on average EUR 19,581.08. Costs of treatment of CF patients over the last 15 years varied between the countries and ranged from EUR 23,330.82 in Bulgaria to EUR 68,696.42 in the United States. CF is an international problem. The data in this study could be the baseline for integrated and harmonised approaches for periodical assessment of the future impact of new public policies and interventions for rare diseases at the national and international levels. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  19. Does cognitive training improve internal locus of control among older adults?

    Science.gov (United States)

    Wolinsky, Fredric D; Vander Weg, Mark W; Martin, René; Unverzagt, Frederick W; Willis, Sherry L; Marsiske, Michael; Rebok, George W; Morris, John N; Ball, Karlene K; Tennstedt, Sharon L

    2010-09-01

    We evaluated the effect of cognitive training among 1,534 participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial (RCT) on 5-year improvements in 3 cognitive-specific measures of locus of control-internal, chance, and powerful others. ACTIVE was a multisite RCT (age > or = 65), with 4 groups (memory, reasoning, speed of processing, and no-contact control). Complete 5-year follow-up data were available for 1,534 (55%) of the 2,802 participants. A propensity score model was used to adjust for potential attrition bias. Clinically important improvements (and decrements) in the cognitive-specific locus of control scale scores were defined as greater than or equal to 0.5 SD (medium) and greater than or equal to 1.0 SD (large). Multinomial logistic regression was used to simultaneously contrast those who improved and those who declined with those whose locus of control scale score was unchanged. Statistically significant effects reflecting medium-sized (> or = 0.5 SD) improvements in internal locus of control between baseline and the 5-year follow-up were found for the reasoning and speed of processing intervention groups who were 76% (p control group. No improvement effects were found on the chance or powerful others locus of control measures or for the memory intervention group. Cognitive training that targets reasoning and speed of processing can improve the cognitive-specific sense of personal control over one's life in older adults.

  20. Associations among Measures of Sequential Processing in Motor and Linguistics Tasks in Adults with and without a Family History of Childhood Apraxia of Speech: A Replication Study

    Science.gov (United States)

    Button, Le; Peter, Beate; Stoel-Gammon, Carol; Raskind, Wendy H.

    2013-01-01

    The purpose of this study was to address the hypothesis that childhood apraxia of speech (CAS) is influenced by an underlying deficit in sequential processing that is also expressed in other modalities. In a sample of 21 adults from five multigenerational families, 11 with histories of various familial speech sound disorders, 3 biologically…

  1. The need for control, safety and trust in healthcare: A qualitative study among adolescents and young adults exposed to family violence

    NARCIS (Netherlands)

    Rosmalen-Nooijens, K.A.W.L. van; Lo Fo Wong, S.H.; Prins, J.B.; Lagro-Janssen, A.L.M.

    2017-01-01

    OBJECTIVE: Adolescents and young adults (AYA) exposed to family violence are in need of professional healthcare. However, only one-third of them seek professional help. METHODS: This study investigates healthcare needs of twelve AYA exposed to family violence. Semi-structured face-to-face interviews

  2. Long-Term Impact of Family Arguments and Physical Violence on Adult Functioning at Age 30 Years: Findings from the Simmons Longitudinal Study

    Science.gov (United States)

    Paradis, Angela D.; Reinherz, Helen Z.; Giaconia, Rose M.; Beardslee, William R.; Ward, Kirsten; Fitzmaurice, Garrett M.

    2009-01-01

    Family arguments by the age of 15 and family physical violence by the age of 18 is found to significantly compromise key domains of adult functioning at age 30. The findings are based on data from 346 participants whose psychosocial development has been followed since age 5.

  3. The role of attitudes and culture in family caregiving for older adults.

    Science.gov (United States)

    Anngela-Cole, Linda; Hilton, Jeanne M

    2009-01-01

    This study evaluated cultural differences in attitudes toward caregiving and the stress levels of family caregivers. Participants included 98 Japanese American and 86 Caucasian American family caregivers caring for frail elders. Analyses using MANOVA and multiple regression analyses revealed that the Caucasian caregivers had more positive attitudes and provided more hours of care than the Japanese caregivers but that both groups had elevated levels of caregiver stress. The stress that family caregivers currently experience could lead to a future generation of care recipients who enter old age in worse condition than their predecessors. Professionals need to work together to develop culturally appropriate, evidence-based interventions to address this issue.

  4. Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali.

    Science.gov (United States)

    Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan

    2017-06-27

    Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing, can successfully create demand for a broad range of family

  5. Increasing Access to Family Planning Choices Through Public-Sector Social Franchising: The Experience of Marie Stopes International in Mali

    Science.gov (United States)

    Gold, Judy; Burke, Eva; Cissé, Boubacar; Mackay, Anna; Eva, Gillian; Hayes, Brendan

    2017-01-01

    Background: Mali has one of the world's lowest contraceptive use rates and a high rate of unmet need for family planning. In order to increase access to and choice of quality family planning services, Marie Stopes International (MSI) Mali introduced social franchising in public-sector community health centers (referred to as CSCOMs in Mali) in 3 regions under the MSI brand BlueStar. Program Description: Potential franchisees are generally identified from CSCOMs who have worked with MSI outreach teams; once accredited as franchisees, CSCOMs receive training, supervision, family planning consumables and commodities, and support for awareness raising and demand creation. To ensure availability and affordability of services, franchisees are committed to providing a wide range of contraceptive methods at low fixed prices. Methods and Results: The performance of the BlueStar network from inception in March 2012 until December 2015 was examined using information from routine monitoring data, clinical quality audits, and client exit interviews. During this period, the network grew from 70 to 135 franchisees; an estimated 123,428 clients received voluntary family planning services, most commonly long-acting reversible methods of contraception. Franchisee efficiency and clinical quality of services increased over time, and client satisfaction with services remained high. One-quarter of clients in 2015 were under 20 years old, and three-quarters were adopters of family planning (that is, they had not been using a modern method during the 3 months prior to their visit). Conclusion: Applying a social franchising support package, originally developed for for-profit private-sector providers, to public-sector facilities in Mali has increased access, choice, and use of family planning in 3 regions of Mali. The experience of BlueStar Mali suggests that interventions that support quality supply of services, while simultaneously addressing demand-side barriers such as service pricing

  6. Think adult-think child! Why should staff caring for dying adults ask what the death means for children in the family?

    Science.gov (United States)

    Aynsley-Green, Sir Al

    2017-09-01

    Bereaved children and young people in the UK are 'hidden mourners'. Review of primary and secondary evidence on childhood bereavement. Children experience grief that varies according to the circumstance of death and their cognitive ability. Voluntary organizations can be supportive, but provision is patchy and vulnerable to austerity. Adult-centric denial of the importance and long-term consequences of childhood grief; uncertainty in how best to relate to bereaved children in faiths and in schools. Increased awareness of the immediate and long-term consequences of childhood bereavement; even young children can experience loss through death. Better knowledge of the numbers of affected children; longitudinal data to track experiences and outcomes; measuring effectiveness of different approaches; identifying risk factors for early intervention in complicated or prolonged grief; the importance of faith and rituals around death; mapping the provision of services to monitor the impact of austerity. 'Think adult-think child' means that all staff caring for dying adults should take responsibility for asking what the death means for the children in the family, with schools, primary care and faith organizations having protocols and expertise available to support grieving children; recent catastrophes expose need for agencies to have management plans that focus on vulnerable children and young people. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  7. Validation of the Omron M6 (HEM-7001-E) upper-arm blood pressure measuring device according to the International Protocol in adults and obese adults.

    Science.gov (United States)

    Altunkan, Sekip; Ilman, Nevzat; Kayatürk, Nur; Altunkan, Erkan

    2007-08-01

    Electronic blood pressure (BP) measurement devices are the preferred choice of patients owing to their user-friendly nature; however, there is a requirement to investigate the accuracy and reliability of these devices. The objective of this study is to evaluate the accuracy of the Omron M6 upper-arm BP device against the mercury sphygmomanometer in adults and obese adults according to the International Protocol criteria. One hundred and twenty-one patients, older than 30 years of age, were studied and classified on the basis of the range of the International Protocol. BP measurements at the upper arm with the Omron M6 were compared with the results obtained by two trained observers using a mercury sphygmomanometer. Nine sequential BP measurements were taken. A total of 33 participants were selected for each validation study. During the validation study, 99 measurements were performed on 33 participants for comparison. The first phase was performed on 15 participants, and if the device passed this phase, 18 more participants were selected. Having a two-fold purpose, this study was conducted on both adult and obese adult patients. Mean discrepancies and standard deviations of the monitor-mercury sphygmomanometer were 1.1+/-4.0 mmHg for systolic BP (SBP) and -0.5+/-3.5 mmHg for diastolic BP (DBP) in the adult group. The device passed phase 1 in 15 participants. In phase 2.1, out of a total of 99 comparisons, 88, 96, and 97 for SBP, and 88, 98, and 99 for DBP were M6 automatic monitor, which measures BP at the upper arm, produced results in accordance with the criteria of phases 2.1 and 2.2 in both SBP and DBP, when applied to adults and to obese adults. It was concluded that the Omron M6 device, which measures BP at the upper arm, was deemed to be in accordance with the International Protocol criteria and can be recommended for use by adults and obese adults.

  8. "It is our exercise family": experiences of ethnic older adults in a group-based exercise program.

    Science.gov (United States)

    Chiang, Kuan-Chun; Seman, Leslie; Belza, Basia; Tsai, Jenny Hsin-Chun

    2008-01-01

    Enhance Fitness (EF) (formerly the Lifetime Fitness Program) is an evidence-based community exercise program for older adults. From 1998 to 2005, participation of ethnic older adults increased significantly. However, little research is available about what ethnic older adults want or need to continue participation in exercise programs. The purpose of this study was to examine how physical environment, social environment, and individual biology and behavior influence adherence to exercise for ethnic older adults participating in EF. Six focus groups were conducted with 52 older adults participating in EF. Facilitators asked questions about factors that helped participants continue exercising in EF. Interviews were audiotaped and transcribed. Transcripts were systematically reviewed using content analysis. Focus group participants were Chinese (n = 21, 40%), African American (n = 18, 35%), white (n = 10, 19%), and Japanese (n = 3, 6%). Mean (SD) age was 76 years (7.4). Participants had, on average, participated in EF for 44 months (SD = 37.8). Results revealed four themes related to adherence. First, environmental factors that promoted adherence were location of the classes, transportation, weather, and the facility. Second, design of the exercise program that encouraged adherence included exercise content and type of delivery. Third, social support factors that encouraged adherence were the socializing and support between class participants and support from family, health care providers, and the class instructors. Finally, individual factors that encouraged adherence were personality traits and feelings, past physical activity experience, health benefits, and mental stimulation. Findings from this study suggest strategies for developing community-based physical activity programs for older adults from ethnically diverse communities.

  9. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA)

    DEFF Research Database (Denmark)

    Goertz, Christine M; Salsbury, Stacie A; Vining, Robert D

    2013-01-01

    commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient......-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. METHODS/DESIGN: This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least...... one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain...

  10. Familial atypical multiple mole melanoma syndrome in an adult Indian male-case report and literature review

    Directory of Open Access Journals (Sweden)

    Radhika C G Raj

    2015-01-01

    Full Text Available Familial atypical multiple mole melanoma syndrome (FAMMMS is an autosomal dominant genodermatosis characterized by multiple melanocytic nevi, usually more than 50, and a family history of melanoma. It is known to be associated with carcinoma of pancreas and other malignancies involving gastrointestinal tract, breast, lung, larynx, and skin in the kindred. There is no published report of FAMMMS in dark-skinned individuals. We report a case of FAMMMS in a dark-skinned adult Indian male, who had multiple extensive nevi all over the body and oral mucosa; associated with malignant melanoma, squamous cell carcinoma (Marjolin′s ulcer, and carcinoma of pancreas. His father had died of carcinoma of lung and his sister had a partial phenotypic expression. The clinical presentation of the case is discussed with review of literature.

  11. The role of hypoglycemia in the burden of living with diabetes among adults with diabetes and family members

    DEFF Research Database (Denmark)

    Nefs, Giesje; Pouwer, François

    2018-01-01

    -severe hypoglycemia in the past year (OR = 2.45, 1.25-4.83), self-reported severe hypoglycemia in the past year (OR = 1.91, 1.02-3.58), and being very worried about hypoglycemia at least occasionally (OR = 3.64, 2.18-6.10). For family members, the odds of experiencing living with diabetes as a burden was increased......, 412 Dutch adults with type 1 or type 2 diabetes and 86 family members completed questions about the burden of living with diabetes, the frequency of hypoglycemia, worries about these events, and several demographic and clinical factors. Analyses included hierarchical logistic regression. RESULTS...

  12. Adult family members and their resemblance of coronary heart disease risk factors: The Cardiovascular Disease Study in Finnmark

    International Nuclear Information System (INIS)

    Brenn, Tormod

    1997-01-01

    Coronary heart disease tends to run in families, and the familial resemblance of major risk factors for the disease was examined among various types of adult family members. Family units were assembled from a total of 4,738 men and women who took part in a cross sectional health survey in four Norwegian municipalities where all inhabitants between 20 and 52 years of age were invited. After adjusting for age and other confounders, correlation coefficients were derived as a measure of the degree of resemblance. Viewed across all types of investigated familial relationships, similarity was found to be stronger for total cholesterol than for high-density lipoprotein cholesterol and triglycerides, and also stronger for systolic than for diastolic blood pressure. Between husbands and wives (3,060 subjects), correlations were small (between 0.02 and 0.06), except for 0.11 for total cholesterol. Lipid and blood pressure correlations ranged from 0.13 to 0.27 for parents and their offspring (471 subjects, p < 0.05) and from 0.11 to 0.22 among siblings (2,166 subjects, p < 0.01). Sibling correlations were consistent across age groups. Furthermore, reports from each individual on daily smoking (yes or no) revealed that husbands and wives had similar habits in 63.5% of all marriages as compared with the expected 49.4% had no smoking similarity at all been present. Smoking concordance was also demonstrated among siblings (p < 0.01). The persistent pattern of lipid and blood pressure aggregation among genetically related individuals from 20 to 52 years of age and the much weaker such similarity between husbands and wives, point towards genes or commonly shared environment at early ages as a major reason why coronary heart disease runs in families

  13. Family caregiving for older adults : gendered roles and caregiver burden in emigrant households of Kerala, India

    NARCIS (Netherlands)

    Ugargol, Allen Prabhaker; Bailey, Ajay

    2018-01-01

    The Indian state of Kerala leads the demographic transition and characteristically showcases emigration of predominantly male adult children, leaving behind parents, spouses and children. When men emigrate, gendered contexts burden women, especially spouses and daughters-in-law, with caregiving

  14. A novel potential biomarker for metabolic syndrome in Chinese adults: Circulating protein disulfide isomerase family A, member 4.

    Science.gov (United States)

    Chien, Chu-Yen; Hung, Yi-Jen; Shieh, Yi-Shing; Hsieh, Chang-Hsun; Lu, Chieh-Hua; Lin, Fu-Huang; Su, Sheng-Chiang; Lee, Chien-Hsing

    2017-01-01

    Protein disulfide isomerase (PDI) family members are specific endoplasmic reticulum proteins that are involved in the pathogenesis of numerous diseases including neurodegenerative diseases, cancer and obesity. However, the metabolic effects of PDIA4 remain unclear in humans. The aims of this study were to investigate the associations of serum PDIA4 with the metabolic syndrome (MetS) and its components in Chinese adults. A total of 669 adults (399 men and 270 women) were recruited. Serum PDIA4 concentrations and biochemical variables were recorded. Insulin sensitivity and β-cell function were examined by homeostasis model assessment. MetS was defined based on the modified National Cholesterol Education Program Adult Treatment Panel III criteria for Asia Pacific. The participants with MetS had significantly higher serum PDIA4 levels than those without MetS (Pmetabolic syndrome were 67 and 72%, respectively, in male patients and 60 and 78%, respectively, in female patients. Finally, the result showed that PDIA4 had a significantly higher area under the curve compared with blood pressure to detect MetS using receiver operating characteristic analysis. Serum PDIA4 concentrations are closely associated to MetS and its components in Chinese adults.

  15. An LMNB1 Duplication Caused Adult-Onset Autosomal Dominant Leukodystrophy in Chinese Family: Clinical Manifestations, Neuroradiology and Genetic Diagnosis

    Directory of Open Access Journals (Sweden)

    Yi Dai

    2017-07-01

    Full Text Available Autosomal dominant adult-onset demyelinating leukodystrophy (ADLD is a very rare neurological disorder featured with late onset, slowly progressive central nervous system demyelination. Duplication or over expression of the lamin B1 (LMNB1 gene causes ADLD. In this study, we undertook a comprehensive clinical evaluation and genetic detection for a Chinese family with ADLD. The proband is a 52-year old man manifested with autonomic abnormalities, pyramidal tract dysfunction. MRI brain scan identified bilateral symmetric white matter (WM hyper-intensities in periventricular and semi-oval WM, cerebral peduncles and middle cerebellar peduncles. The proband has a positive autosomal dominant family history with similar clinical manifestations with a trend of genetic anticipation. In order to understand the genetic cause of the disease in this family, target exome capture based next generation sequencing has been done, but no causative variants or possibly pathogenic variants has been identified. However, Multiplex ligand-dependent probe amplification (MLPA showed whole duplication of LMNB1 gene which is co-segregated with the disease phenotype in this family. This is the first genetically confirmed LMNB1 associated ADLD pedigree from China.

  16. Eliciting Preferences of Multimorbid Elderly Adults in Family Practice Using an Outcome Prioritization Tool

    NARCIS (Netherlands)

    van Summeren, Jojanneke J. G. T.; Haaijer-Ruskamp, Flora M.; Schuling, Jan

    2016-01-01

    ObjectivesTo explore an outcome prioritization tool (OPT) in eliciting individuals' preferred health outcomes (remaining alive, maintaining independence, reducing pain, reducing other symptoms) in the context of medication review in family practice. DesignCross-sectional pilot study with

  17. Neuropsychological performance and family history in children at age 7 who develop adult schizophrenia or bipolar psychosis in the New England Family Studies.

    Science.gov (United States)

    Seidman, L J; Cherkerzian, S; Goldstein, J M; Agnew-Blais, J; Tsuang, M T; Buka, S L

    2013-01-01

    Persons developing schizophrenia (SCZ) manifest various pre-morbid neuropsychological deficits, studied most often by measures of IQ. Far less is known about pre-morbid neuropsychological functioning in individuals who later develop bipolar psychoses (BP). We evaluated the specificity and impact of family history (FH) of psychosis on pre-morbid neuropsychological functioning. We conducted a nested case-control study investigating the associations of neuropsychological data collected systematically at age 7 years for 99 adults with psychotic diagnoses (including 45 SCZ and 35 BP) and 101 controls, drawn from the New England cohort of the Collaborative Perinatal Project (CPP). A mixed-model approach evaluated full-scale IQ, four neuropsychological factors derived from principal components analysis (PCA), and the profile of 10 intelligence and achievement tests, controlling for maternal education, race and intra-familial correlation. We used a deviant responder approach (children who later develop SCZ, especially in the SCZ FH+ subgroup, but less so in BP, suggesting especially impaired neurodevelopment underlying cognition in pre-SCZ children. Future work should assess genetic and environmental factors that explain this FH effect.

  18. The impact of migration on family solidarity types

    NARCIS (Netherlands)

    Baykara-Krumme, H.; Fokkema, T.

    2017-01-01

    This paper aims to expand knowledge on the effects of international migration on parent-adult child relationships. We develop a typology of families, include non-migrant families in the country of origin for comparison, and consider transnational families. Analyses are based on the Turkish 2000

  19. Depression, Sex and Gender Roles in Older Adult Populations: The International Mobility in Aging Study (IMIAS).

    Science.gov (United States)

    Vafaei, Afshin; Ahmed, Tamer; Freire, Aline do N Falcão; Zunzunegui, Maria Victoria; Guerra, Ricardo O

    2016-01-01

    To assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression. International cross-sectional study of adults between 65 and 74 years old (n = 1,967). Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D). A validated 12-item Bem Sex Role Inventory (BSRI) was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated) using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR) of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions. Among men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were 32.7%, 14.9%, 27%, and 25.4%. Both in men and in women, depressive symptoms (CES-D≥16) were more prevalent in those endorsing the undifferentiated type, compared to masculine, feminine or androgynous groups. However, after adjusting for potential confounders, compared to the masculine group only those endorsing the androgynous role were 28% less likely to suffer from depression: PR of 0.72 (95% CI: 0.55-0.93). In fully adjusted models, prevalence rates of depression were not different from masculine participants in the two other gender groups of feminine and undifferentiated. Androgynous roles were associated with lower rates of depression in older adults, independently of being a man or a woman.

  20. Depression, Sex and Gender Roles in Older Adult Populations: The International Mobility in Aging Study (IMIAS.

    Directory of Open Access Journals (Sweden)

    Afshin Vafaei

    Full Text Available To assess the associations between gender roles and depression in older men and women and whether gender roles are independent risk factors for depression.International cross-sectional study of adults between 65 and 74 years old (n = 1,967. Depression was defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale (CES-D. A validated 12-item Bem Sex Role Inventory (BSRI was used to classify participants in gender roles (Masculine, Feminine, Androgynous, and Undifferentiated using research site medians of femininity and masculinity as cut-off points. Poisson regressions were fitted to estimate the prevalence ratios (PR of depression for each gender role compared to the masculine role, adjusting for sex, sufficiency of income, education, marital status, self-rated health, and chronic conditions.Among men, 31.2% were androgynous, 26% were masculine, 14.4% were feminine, and 28.4% were undifferentiated; among women, the corresponding percentages were 32.7%, 14.9%, 27%, and 25.4%. Both in men and in women, depressive symptoms (CES-D≥16 were more prevalent in those endorsing the undifferentiated type, compared to masculine, feminine or androgynous groups. However, after adjusting for potential confounders, compared to the masculine group only those endorsing the androgynous role were 28% less likely to suffer from depression: PR of 0.72 (95% CI: 0.55-0.93. In fully adjusted models, prevalence rates of depression were not different from masculine participants in the two other gender groups of feminine and undifferentiated.Androgynous roles were associated with lower rates of depression in older adults, independently of being a man or a woman.

  1. Internalizing problem behavior and family environment of children with burns: A Dutch pilot study

    NARCIS (Netherlands)

    Liber, J.M.; List, D.; van Loey, N.E.E.; Kef, S.

    2006-01-01

    The psychosocial development of children with burns is at risk. Children with health care issues tend to develop internalizing problems. Several areas of protective or risk factors were composed into a conceptual model on how internalizing problems might develop or might be prevented after getting

  2. Gender nonconformity and mental health among lesbian, gay, and bisexual adults: Homophobic stigmatization and internalized homophobia as mediators.

    Science.gov (United States)

    Van Beusekom, Gabriël; Bos, Henny Mw; Kuyper, Lisette; Overbeek, Geertjan; Sandfort, Theo Gm

    2016-04-01

    We assessed among a sample of 724 Dutch lesbian, gay, and bisexual-identified adults ( M age  = 31.42) whether experiences with homophobic stigmatization and internalized homophobia simultaneously mediated the relation of gender nonconformity with mental health. Results indicated that homophobic stigmatization and internalized homophobia partially mediated the relation between gender nonconformity and mental health. Gender nonconformity was related to more mental health problems via increased experiences with homophobic stigmatization and to less mental health problems because of reduced levels of internalized homophobia. However, the mediated relation of gender nonconformity with mental health via homophobic stigmatization was only significant for men.

  3. International comparison of cost of falls in older adults living in the community: a systematic review.

    Science.gov (United States)

    Davis, J C; Robertson, M C; Ashe, M C; Liu-Ambrose, T; Khan, K M; Marra, C A

    2010-08-01

    Our objective was to determine international estimates of the economic burden of falls in older people living in the community. Our systematic review emphasized the need for a consensus on methodology for cost of falls studies to enable more accurate comparisons and subgroup-specific estimates among different countries. The purpose of this study was to determine international estimates of the economic burden of falls in older people living in the community. This is a systematic review of peer-reviewed journal articles reporting estimates for the cost of falls in people aged > or =60 years living in the community. We searched for papers published between 1945 and December 2008 in MEDLINE, PUBMED, EMBASE, CINAHL, Cochrane Collaboration, and NHS EED databases that identified cost of falls in older adults. We extracted the cost of falls in the reported currency and converted them to US dollars at 2008 prices, cost items measured, perspective, time horizon, and sensitivity analysis. We assessed the quality of the studies using a selection of questions from Drummond's checklist. Seventeen studies met our inclusion criteria. Studies varied with respect to viewpoint of the analysis, definition of falls, identification of important and relevant cost items, and time horizon. Only two studies reported a sensitivity analysis and only four studies identified the viewpoint of their economic analysis. In the USA, non-fatal and fatal falls cost US $23.3 billion (2008 prices) annually and US $1.6 billion in the UK. The economic cost of falls is likely greater than policy makers appreciate. The mean cost of falls was dependent on the denominator used and ranged from US $3,476 per faller to US $10,749 per injurious fall and US $26,483 per fall requiring hospitalization. A consensus on methodology for cost of falls studies would enable more accurate comparisons and subgroup-specific estimates among different countries.

  4. Histological and Transcriptomic Analysis of Adult Japanese Medaka Sampled Onboard the International Space Station.

    Directory of Open Access Journals (Sweden)

    Yasuhiko Murata

    Full Text Available To understand how humans adapt to the space environment, many experiments can be conducted on astronauts as they work aboard the Space Shuttle or the International Space Station (ISS. We also need animal experiments that can apply to human models and help prevent or solve the health issues we face in space travel. The Japanese medaka (Oryzias latipes is a suitable model fish for studying space adaptation as evidenced by adults of the species having mated successfully in space during 15 days of flight during the second International Microgravity Laboratory mission in 1994. The eggs laid by the fish developed normally and hatched as juveniles in space. In 2012, another space experiment ("Medaka Osteoclast" was conducted. Six-week-old male and female Japanese medaka (Cab strain osteoblast transgenic fish were maintained in the Aquatic Habitat system for two months in the ISS. Fish of the same strain and age were used as the ground controls. Six fish were fixed with paraformaldehyde or kept in RNA stabilization reagent (n = 4 and dissected for tissue sampling after being returned to the ground, so that several principal investigators working on the project could share samples. Histology indicated no significant changes except in the ovary. However, the RNA-seq analysis of 5345 genes from six tissues revealed highly tissue-specific space responsiveness after a two-month stay in the ISS. Similar responsiveness was observed among the brain and eye, ovary and testis, and the liver and intestine. Among these six tissues, the intestine showed the highest space response with 10 genes categorized as oxidation-reduction processes (gene ontogeny term GO:0055114, and the expression levels of choriogenin precursor genes were suppressed in the ovary. Eleven genes including klf9, klf13, odc1, hsp70 and hif3a were upregulated in more than four of the tissues examined, thus suggesting common immunoregulatory and stress responses during space adaptation.

  5. Dietary intakes and serum nutrients differ between adults from food-insufficient and food-sufficient families: Third National Health and Nutrition Examination Survey, 1988-1994.

    Science.gov (United States)

    Dixon, L B; Winkleby, M A; Radimer, K L

    2001-04-01

    Approximately 10.2 million persons in the United States sometimes or often do not have enough food to eat, a condition known as food insufficiency. Using cross-sectional data from the Third National Health and Nutrition Examination Survey (NHANES III), we examined whether dietary intakes and serum nutrients differed between adults from food-insufficient families (FIF) and adults from food-sufficient families (FSF). Results from analyses, stratified by age group and adjusted for family income and other important covariates, revealed several significant findings (P milk/milk products, fruits/fruit juices and vegetables. In addition, younger adults from FIF had lower serum concentrations of total cholesterol, vitamin A and three carotenoids (alpha-carotene, beta-cryptoxanthin and lutein/zeaxanthin). Older adults (aged > or =60 y) from FIF had lower intakes of energy, vitamin B-6, magnesium, iron and zinc and were more likely to have iron and zinc intakes below 50% of the recommended amount on a given day. Older adults from FIF also had lower serum concentrations of high-density lipoprotein cholesterol, albumin, vitamin A, beta-cryptoxanthin and vitamin E. Both younger and older adults from FIF were more likely to have very low serum albumin (<35 g/L) than were adults from FSF. Our findings show that adults from FIF have diets that may compromise their health.

  6. Skills of U.S. Unemployed, Young, and Older Adults in Sharper Focus: Results from the Program for the International Assessment of Adult Competencies (PIAAC) 2012/2014. First Look. NCES 2016-039

    Science.gov (United States)

    Rampey, Bobby D.; Finnegan, Robert; Goodman, Madeline; Mohadjer, Leyla; Krenzke, Tom; Hogan, Jacquie; Provasnik, Stephen

    2016-01-01

    The "Program for the International Assessment of Adult Competencies" (PIAAC) is a cyclical, large-scale study of adult skills and life experiences focusing on education and employment. Nationally representative samples of adults between the ages of 16 and 65 are administered an assessment of literacy, numeracy, and problem solving in…

  7. A Six-Year Predictive Test of Adolescent Family Relationship Quality and Effortful Control Pathways to Emerging Adult Social and Emotional Health

    Science.gov (United States)

    Fosco, Gregory M.; Caruthers, Allison S.; Dishion, Thomas J.

    2012-01-01

    This longitudinal study examined how a multimethod (youth report, parent report, direct observation) assessment of family relationship quality (cohesion and conflict) in adolescence (age 16 –17) predicted growth and maintenance of effortful control across ages 17, 22, and 23 years old, and, ultimately, subjective well-being, emotional distress, and aggressive behavior in emerging adulthood (23). A diverse sample of 792 youth at age 17 and their families, and youth at ages 22 and 23, were studied to examine family cohesion and conflict and the growth and maintenance of effortful control as predictors of emerging adult social and emotional health. Results indicated that family cohesion and conflict during late adolescence and mean-level effortful control at age 22 each served as unique pathways to emerging adult adjustment. These findings underscore the importance of family functioning during adolescence and the maintenance of effortful control into emerging adulthood for understanding adjustment during the emerging adulthood period. PMID:22709261

  8. Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study.

    Science.gov (United States)

    Torke, Alexia M; Callahan, Christopher M; Sachs, Greg A; Wocial, Lucia D; Helft, Paul R; Monahan, Patrick O; Slaven, James E; Montz, Kianna; Burke, Emily S; Inger, Lev

    2018-03-01

    Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient's hospitalization. To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults. Observational study at three hospitals in a Midwest metropolitan area. Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study. Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4-6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems). The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate-severe anxiety); 29% reported depression, (14.0% moderate-severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = -0.30, p = 0.003) and higher decision quality (β = -0.44, p post-traumatic stress (β = 0.23, p = 0.022) but also higher satisfaction (β = 0

  9. Specific absorbed fractions of energy at various ages from internal photon sources: 7, Adult male

    International Nuclear Information System (INIS)

    Cristy, M.; Eckerman, K.F.

    1987-04-01

    Specific absorbed fractions (PHI's) in various organs of the body (target organs) from sources of monoenergetic photons in various other organs (source organs) are tabulated. In this volume PHI-values are tabulated for an adult male (70-kg Reference Man). These PHI-values can be used in calculating the photon component of the dose-equivalent rate in a given target organ from a given radionuclide that is present in a given source organ. The International Commission on Radiological Protection recognizes that the endosteal, or bone surface, cells are the tissue at risk for bone cancer. We have applied the dosimetry methods developed for beta-emitting radionuclides deposited in bone to follow the transport of secondary electrons that were freed by photon interactions through the microscopic structure of the skeleton. With these methods we can estimate PHI in the endosteal cells and can better estimate PHI in the active marrow; the latter is overestimated with other methods at photon energies below 200 keV. 12 refs., 2 tabs

  10. Ethical and Regulatory Challenges with Autologous Adult Stem Cells: A Comparative Review of International Regulations.

    Science.gov (United States)

    Lysaght, Tamra; Kerridge, Ian H; Sipp, Douglas; Porter, Gerard; Capps, Benjamin J

    2017-06-01

    Cell and tissue-based products, such as autologous adult stem cells, are being prescribed by physicians across the world for diseases and illnesses that they have neither been approved for or been demonstrated as safe and effective in formal clinical trials. These doctors often form part of informal transnational networks that exploit differences and similarities in the regulatory systems across geographical contexts. In this paper, we examine the regulatory infrastructure of five geographically diverse but socio-economically comparable countries with the aim of identifying similarities and differences in how these products are regulated and governed within clinical contexts. We find that while there are many subtle technical differences in how these regulations are implemented, they are sufficiently similar that it is difficult to explain why these practices appear more prevalent in some countries and not in others. We conclude with suggestions for how international governance frameworks might be improved to discourage the exploitation of vulnerable patient populations while enabling innovation in the clinical application of cellular therapies.

  11. A qualitative study of intimate partner violence universal screening by family therapy interns: implications for practice, research, training, and supervision.

    Science.gov (United States)

    Todahl, Jeffrey L; Linville, Deanna; Chou, Liang-Ying; Maher-Cosenza, Patricia

    2008-01-01

    Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.

  12. The Future of Family and Consumer Sciences (FCS) and Home Economics: An International and Intergenerational Vignette

    NARCIS (Netherlands)

    McGregor, Sue L.T.; Hustvedt, G.; Smith, M.G.; Roubanis, J.L.; Lee, S.J.; Scholl, J.; Makela, C.J.; Wahlen, S.; Goldsmith, E.B.; Chen, P.; DeVaney, S.A.; West, G.E.; Murnane, J.; Turkki, Kaija

    2015-01-01

    This unique Feature article comprises a collage of contributions submitted by family and consumer sciences (FCS) practitioners from around the world (also called home economics, human ecology, and human sciences). As Interim Editor (this is my last issue), I reached out to FCS/home economists from

  13. Experiences and Coping Strategies of Host Families in International Youth Exchange

    Science.gov (United States)

    Weidemann, Arne; Bluml, Frances

    2009-01-01

    Twenty narrative interviews were conducted with German host parents between 2006 and 2007 about their experiences with a one-year stay of a guest student in their family. The study took place within the context of a student research project as part of the research-oriented MA course "Intercultural Communication-Intercultural Competence"…

  14. Remission of Maternal Depression: Relations to Family Functioning and Youth Internalizing and Externalizing Symptoms

    Science.gov (United States)

    Foster, Cynthia Ewell; Webster, Melissa C.; Weissman, Myrna M.; Pilowsky, Daniel J.; Wickramaratne, Priya J.; Talati, Ardesheer; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; Cerda, Gabrielle; Kornstein, Susan G.; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Fava, Maurizio; King, Cheryl A.

    2008-01-01

    Family functioning and parenting were hypothesized to mediate the relation between remission of maternal depression and children's psychosocial adjustment. Participants were 114 mother-child dyads participating in the Sequenced Treatment Alternatives to Relieve Depression Child 3-month follow-up. All mothers had been diagnosed with major…

  15. How Private Is the Relation with God? Religiosity and Family Religious Socialization in Romanian Emerging Adults

    Science.gov (United States)

    Negru, Oana; Haragâs, Cosmina; Mustea, Anca

    2014-01-01

    This qualitative study explores the dynamics of religious cognitions, behaviors, and emotions in emerging adult discourse in a sample of Romanian youth of heterogeneous socioeconomic, denominational (Orthodox Christian, Roman Catholic, Neo-protestant), and educational background. Also, from a parent-child dyad perspective, we investigate the role…

  16. Balancing Work, Family, and Student Roles: A Phenomenological Study of the Adult Female Graduate Online Learner

    Science.gov (United States)

    Rousseau, Charlene X.

    2012-01-01

    The purpose of this phenomenological study was to gain an understanding of the lived experiences of female adult learners pursuing graduate degrees online. As online graduate programs have become increasingly popular and more readily available in the last decade, more women than men are enrolling in online graduate programs in addition to…

  17. Outcome in Adult Life for People with Williams Syndrome Results from a Survey of 239 Families

    Science.gov (United States)

    Howlin, P.; Udwin, O.

    2006-01-01

    BACKGROUND: Although there has been considerable research into the genotype and phenotype of Williams syndrome, there have been relatively few studies of long-term prognosis. As a preliminary to a more detailed investigation of adults with Williams syndrome, a parental questionnaire was distributed to members of the UK Williams Syndrome…

  18. Family history predicts major adverse cardiovascular events (MACE) in young adults with psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Bruun, Louise E; Mallbris, Lotus

    2016-01-01

    BACKGROUND: Patients with psoriasis may have increased risk of major adverse cardiovascular (CV) events (MACE), and a family history of CV disease (CVD) is an independent risk factor for MACE. OBJECTIVE: We investigated the risk of first-time MACE in patients with psoriasis with or without a fami....... The findings call for increased focus on a family history of CVD in CV risk assessment of patients with psoriasis.......BACKGROUND: Patients with psoriasis may have increased risk of major adverse cardiovascular (CV) events (MACE), and a family history of CV disease (CVD) is an independent risk factor for MACE. OBJECTIVE: We investigated the risk of first-time MACE in patients with psoriasis with or without a family...... history of CVD. METHODS: Between January 1, 1997, and December 31, 2011, we identified 2,722,375 individuals, including 25,774 and 4504 patients with mild and severe psoriasis, through administrative registers. Incidence rate ratios were estimated by Poisson regression. RESULTS: Mean baseline age was 26...

  19. Helping Students Prepare To Juggle Career and Family: Young Adults Attitudes toward Maternal Employment.

    Science.gov (United States)

    Rowles, Dorothy; Gambone, Kirsten; Szuchyt, Jamie; Deitrick, Susan; Gelband, Amy; Lu, Barbara Chris; Zohe, Dorothy; Stickney, Deborah; Fields, Susan; Chambliss, Catherine

    Counseling students in order to help them make sound educational, career, and personal decisions requires an understanding of their values, priorities, and preconceptions about their options. The present study explored the attitudes of male and female college students regarding maternal employment, and their own career and family expectations, in…

  20. The association of family support and wellbeing in later life depends on adult attachment style

    NARCIS (Netherlands)

    Merz, E.-M.; Consedine, N.S.

    2009-01-01

    The current study examines the association between family support and wellbeing in the elderly, paying particular attention to the possible moderating role of attachment style. Data from a community-dwelling, ethnically diverse, elderly sample (N ¼ 1118) were analyzed to determine the best linear

  1. Predicting Role Conflict, Overload and Contagion in Adult Women University Students with Families and Jobs.

    Science.gov (United States)

    Home, Alice M.

    1998-01-01

    Data from 443 women combining work, family, and schooling showed that lower income increased their vulnerability to role conflict. Perceived intensity of student demands was the strongest predictor of role conflict, overload, and contagion (preoccupation with one role while performing another). Conflict and overload were eased somewhat by distance…

  2. Familial Aggregation of Age-Related Hearing Loss in an Epidemiological Study of Older Adults

    Science.gov (United States)

    Raynor, Laura A.; Pankow, James S.; Miller, Michael B.; Huang, Guan-Hua; Dalton, Dayna; Klein, Ronald; Klein, Barbara E. K.; Cruickshanks, Karen J.

    2010-01-01

    Purpose To estimate the genetic contributions to presbycusis Method Presbycusis was assessed by audiometric measurements at three waves of the population-based Epidemiology of Hearing Loss Study (EHLS). Measurements from the most recent hearing examination were used, at which time subjects were between 48 and 100 years of age. Heritability of presbycusis was estimated using maximum likelihood methods in 973 biological relative pairs from 376 families. Familial aggregation was also evaluated by tetrachoric correlations, odds ratios, and lambda statistics in 594 sibling pairs from 373 sibships. Subjects 3,510 participants from the EHLS study Results The prevalence of presbycusis conformed to previous research, increasing with age and male sex. Heritability estimates for presbycusis adjusted for age, sex, education level, and exposure to work noise exceeded 50%, and siblings of an affected relative were at 30% higher risk. When stratified by sex, estimates of familial aggregation were higher in women than men. Conclusions There is evidence that genetic factors contribute to age-related hearing loss in this population-based sample. The familial aggregation is stronger in women than in men. PMID:19474454

  3. Moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults.

    Science.gov (United States)

    da Silva, Jaqueline Aragoni; da Silva, Kelly Samara; Del Duca, Giovani Firpo; Dos Santos, Priscila Cristina; Wolker, Sofia; de Oliveira, Elusa Santina Antunes; de Barros, Mauro Virgílio Gomes; Nahas, Markus Vinicius

    2016-06-01

    To investigate the moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults. Secondary analysis of the survey "Lifestyle and leisure habits of industry workers" (n=46,981), conducted in 24 Brazilian states (2006-2008). Self-reported information was collected with a previously tested questionnaire. Crude and adjusted logistic regression models were applied to analyze the association between sociodemographic variables (sex, age, marital status, number of children, education, country area and company size) and active commuting to work in different strata of gross family income. To test the moderating effect, an interaction analysis was applied. The proportion of active commuters among low-, medium- and high-income workers was 40.7% (95%CI:40.0%;41.5%), 27.0% (95%CI:26.3;27.6%) and 11.1%, (95%CI:10.5%;11.7%), respectively. The moderating effect of gross family income was confirmed. Men were more likely (OR:1.22 95%CI:1.12;1.32) to commute actively than women among low-income individuals. Active commuting was less likely among older workers in low-(OR30-39:0.90 95%CI: 0.83;0.98; OR≥40: 0.76 95%CI: 0.68;0.85) and medium-income strata (OR30-39:0.87 95%CI:0.80;0.95; OR≥40:0.84 95%CI:0.76;0.93) and among married individuals in high-income strata (OR:0.72 95%IC:0.61;0.84). Adults with lower education (ORhigh:10.80 95%CI:8.47;13.77), working in the south (ORhigh:1.93 95%CI:1.53;2.44) and in small companies (ORlow:2.50 95%CI:2.28;2.74) were more likely to commute actively; however, the magnitude of these associations differed at each income strata. There was an inverse association between gross family income and active commuting. Gross family income acts as a moderator of the association between demographic indicators and active commuting. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Adult care transitioning for adolescents with special health care needs: a pivotal role for family centered care.

    Science.gov (United States)

    Duke, Naomi N; Scal, Peter B

    2011-01-01

    To examine the relationship between having a usual source of care, family centered care, and transition counseling for adolescents with special health care needs. Data are from 18,198 parents/guardians, of youth aged 12-17 years, who participated in the 2005-2006 National Survey of Children With Special Health Care Needs. Linear and logistic regression models were used to define relationships between parent report of identification of a usual place and provider of medical care for their child and counseling on four transition issues: transfer to adult providers, review of future health needs, maintaining health insurance in adulthood, and youth taking responsibility for care. The direct mediating effect of family centered care was evaluated. Youth having a usual source of care (vs. not) were more likely to receive counseling on future health needs (47.4 vs. 33.6%, P needs (56.3 vs. 39.6%, P needs and 94.9% of the effect of a usual source of care on encouragement to take responsibility for care. Study findings support the development of health care delivery models focusing on family centered care to the same degree as other health care access issues.

  5. The nursing team and the family member accompanying adult patients in the hospital context. An exploratory study

    Directory of Open Access Journals (Sweden)

    Thayane Dias dos Santos

    2013-07-01

    Full Text Available Objective. To identify the actions of family members who accompany adult hospitalized patients and to describe the nursing team's role regarding that person. Methodology. In this qualitative, descriptive and exploratory research, a questionnaire was applied to 30 nursing team members at a teaching hospital located in the State of Rio de Janeiro, using open questions. To interpret the answers, thematic analysis was applied to categorize the identified qualitative variables. Results. Eighty-nine percent of the participants were female. When analyzing the information contained in the answers to the questionnaire, two types of actions were found: the actions the companion can perform for his/her relative and the actions the nursing team needs to perform. In each action, the following categories were verified: affective dimension, practical dimension, moral dimension and inclusion of the family in care. According to the nursing team, the companion plays a very important role in emotional support and help with the patient's basic hygiene, although this care should be offered under nursing orientation. Conclusion. Family companions and nursing team members work together to improve the quality of patient care, with positive reflections for their integration in hospital care, which will enhance its continuity in the home-care context.

  6. Support for and aspects of use of educational games in family medicine and internal medicine residency programs in the US: a survey

    OpenAIRE

    Wilson Mark C; Mustafa Reem; Gunukula Sameer; Akl Elie A; Symons Andrew; Moheet Amir; Schünemann Holger J

    2010-01-01

    Abstract Background The evidence supporting the effectiveness of educational games in graduate medical education is limited. Anecdotal reports suggest their popularity in that setting. The objective of this study was to explore the support for and the different aspects of use of educational games in family medicine and internal medicine residency programs in the United States. Methods We conducted a survey of family medicine and internal medicine residency program directors in the United Stat...

  7. Prevalence of Internalized HIV-Related Stigma Among HIV-Infected Adults in Care, United States, 2011-2013.

    Science.gov (United States)

    Baugher, Amy R; Beer, Linda; Fagan, Jennifer L; Mattson, Christine L; Freedman, Mark; Skarbinski, Jacek; Shouse, R Luke

    2017-09-01

    HIV-infected U.S. adults have reported internalized HIV-related stigma; however, the national prevalence of stigma is unknown. We sought to determine HIV-related stigma prevalence among adults in care, describe which socio-demographic groups bear the greatest stigma burden, and assess the association between stigma and sustained HIV viral suppression. The Medical Monitoring Project measures characteristics of U.S. HIV-infected adults receiving care using a national probability sample. We used weighted data collected from June 2011 to May 2014 and assessed self-reported internalized stigma based on agreement with six statements. Overall, 79.1% endorsed ≥1 HIV-related stigma statements (n = 13,841). The average stigma score was 2.4 (out of a possible high score of six). White males had the lowest stigma scores while Hispanic/Latina females and transgender persons who were multiracial or other race had the highest. Although stigma was associated with viral suppression, it was no longer associated after adjusting for age. Stigma was common among HIV-infected adults in care. Results suggest individual and community stigma interventions may be needed, particularly among those who are Stigma was not independently associated with viral suppression; however, this sample was limited to adults in care. Examining HIV-infected persons not in care may elucidate stigma's association with viral suppression.

  8. “Grandma, You Should Do It—It’s Cool” Older Adults and the Role of Family Members in Their Acceptance of Technology

    Science.gov (United States)

    Luijkx, Katrien; Peek, Sebastiaan; Wouters, Eveline

    2015-01-01

    Despite its potential, the acceptance of technology to support the ability to live independently in one’s own home, also called aging in place, is not optimal. Family members may play a key role in technology acceptance by older adults; however, it is not well understood why and how they exert influence. Based on open interviews with 53 community-dwelling older adults, this paper describes the influence of family members, including spouses, on the use of various types of consumer electronics by older adults as was reported by themselves. Such a broad focus enables understanding the use of technology as was reported by older adults, instead of its intended use. Our study reveals that the influence of each family member has its own characteristics. The influence of technology acceptance is a natural and coincidental part of the interaction with spouses and grandchildren in which entertainment and pleasure are prominent. This is also partly true for the influence of children, but their influence also is intentional and driven by concerns. Our study indicates the importance of including all family members when implementing technology in the lives of older adults. Besides information for children about the use(fullness) of devices, it is worthwhile to give grandchildren an important role, because older adults easily adopt their enthusiasm and it might eventually lighten the burden on children. PMID:26690188

  9. "Grandma, You Should Do It--It's Cool" Older Adults and the Role of Family Members in Their Acceptance of Technology.

    Science.gov (United States)

    Luijkx, Katrien; Peek, Sebastiaan; Wouters, Eveline

    2015-12-05

    Despite its potential, the acceptance of technology to support the ability to live independently in one's own home, also called aging in place, is not optimal. Family members may play a key role in technology acceptance by older adults; however, it is not well understood why and how they exert influence. Based on open interviews with 53 community-dwelling older adults, this paper describes the influence of family members, including spouses, on the use of various types of consumer electronics by older adults as was reported by themselves. Such a broad focus enables understanding the use of technology as was reported by older adults, instead of its intended use. Our study reveals that the influence of each family member has its own characteristics. The influence of technology acceptance is a natural and coincidental part of the interaction with spouses and grandchildren in which entertainment and pleasure are prominent. This is also partly true for the influence of children, but their influence also is intentional and driven by concerns. Our study indicates the importance of including all family members when implementing technology in the lives of older adults. Besides information for children about the use(fullness) of devices, it is worthwhile to give grandchildren an important role, because older adults easily adopt their enthusiasm and it might eventually lighten the burden on children.

  10. Families' perception of children / adolescents with language impairment through the International Classification of Functioning, Disability, and Health (ICF-CY).

    Science.gov (United States)

    Ostroschi, Daniele Theodoro; Zanolli, Maria de Lurdes; Chun, Regina Yu Shon

    2017-05-22

    To investigate the perception of family members regarding linguistic conditions and social participation of children and adolescents with speech and language impairments using the International Classification of Functioning, Disability and Health - Children and Youth Version (ICF-CY). Quali-quantitative approach research, in which a survey of medical records of 24 children/adolescents undergoing speech-language therapy and interviews with their family members was conducted. A descriptive analysis of the participants' profiles was performed, followed by a categorization of responses using the ICF-CY. All family members mentioned various aspects of speech/language categorized by the ICF-CY. Initially, they approached it as an organic issue, categorized under the component of Body Functions and Structures. Most reported different repercussions of the speech-language impairments on the domains, such as dealing with stress and speaking, qualified from mild to severe. Participants reported Environmental Factors categorized as facilitators in the immediate family's attitudes and as barriers in the social attitudes. These findings, according to the use of the ICF-CY, demonstrate that the children/adolescents' speech-language impairments, from the families' perception, are primarily understood in the body dimension. However, guided by a broader approach to health, the findings in the Activities and Participation and Environmental Factors demonstrate a broader understanding of the participants of the speech-language impairments. The results corroborate the importance of using the ICF-CY as a health care analysis tool, by incorporating functionality and participation aspects and providing subsidies for the construction of unique therapeutic projects in a broader approach to the health of the group studied.

  11. Increased risk of metabolic disorders in healthy young adults with family history of diabetes: from the Korea National Health and Nutrition Survey.

    Science.gov (United States)

    Moon, Joon Ho; Roh, Eun; Oh, Tae Jung; Kim, Kyoung Min; Moon, Jae Hoon; Lim, Soo; Jang, Hak Chul; Choi, Sung Hee

    2017-01-01

    We assessed the impact of a family history of diabetes on type 2 diabetes, metabolic syndrome, and behavioral traits in young Korean adults. Subjects aged 25-44 years were included, and the presence of a family history of diabetes was obtained by a self-reported questionnaire (the Korea National Health and Nutrition Survey 2010). We compared the prevalence of type 2 diabetes and metabolic syndrome, and other metabolic parameters, including blood pressure and lipid profile. Of 2059 participants, those with a family history of diabetes involving first-degree relatives (n = 489, 23.7%) had a significantly higher prevalence of impaired fasting glucose (14.3 vs. 11.7%) and type 2 diabetes (6.7 vs. 1.8%), compared to those without a family history ( P  metabolic syndrome (21.3 vs. 12.1%, P  family history of diabetes. Among subjects exhibiting normal glucose tolerance (n = 1704), those with a family history of diabetes had higher fasting glucose (89.0 vs. 87.8 mg/dL, P  family history of diabetes. Young adults with a family history of diabetes had an increased risk of type 2 diabetes and metabolic syndrome, even though they currently exhibited a normal glycemic profile. Proactive lifestyle consultation is requested especially among healthy young population with a family history of diabetes.

  12. Integration of internal and external facial features in 8- to 10-year-old children and adults.

    Science.gov (United States)

    Meinhardt-Injac, Bozana; Persike, Malte; Meinhardt, Günter

    2014-06-01

    Investigation of whole-part and composite effects in 4- to 6-year-old children gave rise to claims that face perception is fully mature within the first decade of life (Crookes & McKone, 2009). However, only internal features were tested, and the role of external features was not addressed, although external features are highly relevant for holistic face perception (Sinha & Poggio, 1996; Axelrod & Yovel, 2010, 2011). In this study, 8- to 10-year-old children and adults performed a same-different matching task with faces and watches. In this task participants attended to either internal or external features. Holistic face perception was tested using a congruency paradigm, in which face and non-face stimuli either agreed or disagreed in both features (congruent contexts) or just in the attended ones (incongruent contexts). In both age groups, pronounced context congruency and inversion effects were found for faces, but not for watches. These findings indicate holistic feature integration for faces. While inversion effects were highly similar in both age groups, context congruency effects were stronger for children. Moreover, children's face matching performance was generally better when attending to external compared to internal features. Adults tended to perform better when attending to internal features. Our results indicate that both adults and 8- to 10-year-old children integrate external and internal facial features into holistic face representations. However, in children's face representations external features are much more relevant. These findings suggest that face perception is holistic but still not adult-like at the end of the first decade of life. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Familial adult spinal muscular atrophy associated with the VAPB gene: report of 42 cases in Brazil

    Directory of Open Access Journals (Sweden)

    Victor Kosac

    2013-10-01

    Full Text Available Familial spinal muscular atrophy (FSMA associated with the vesicle-associated membrane protein-associated protein B (VAPB gene is a rare autosomal dominant disease with late onset and slow progression. We studied 10 of 42 patients from 5 families by taking clinical histories and performing physical exams, electrophysiological studies, and genetic tests. All patients presented late onset disease with slow progression characterized by fasciculations, proximal weakness, amyotrophy, and hypoactive deep tendon reflex, except two who exhibited brisk reflex. Two patients showed tongue fasciculations and respiratory insufficiency. Electrophysiological studies revealed patterns of lower motor neuron disease, and genetic testing identified a P56S mutation of the VAPB gene. Although it is a rare motor neuron disease, FSMA with this mutation might be much more prevalent in Brazil than expected, and many cases may be undiagnosed. Genetic exams should be performed whenever it is suspected in Brazil.

  14. Navigating emotions and relationship dynamics: family life review as a clinical tool for older adults during a relocation transition into an assisted living facility.

    Science.gov (United States)

    O'Hora, Kendra A; Roberto, Karen A

    2018-01-16

    Relocation for the purpose of receiving care may be one of the more challenging transitions for older adults. The purpose of this study was to facilitate a family life review (FLR) session aimed at enhancing family relationships and assisting older adults in coping with the challenges associated with a relocation. Fourteen dyads comprised of older adults who relocated to an assisted living facility (ALF) and a chosen family member or friend participated in a FLR session and semi-structured follow up interview. Data were analyzed using the constant comparative method and triangulated with descriptive statistics. Emergent themes suggested participating in FLR influenced families by raising emotions, systemically thinking, and navigating the relocation. FLR facilitated positive connections, enhanced existing relationships, and promoted self-acceptance. Families indicated mutual storytelling was enjoyable and reminded them of the urgency to share their story. FLR allowed dyads to reflect and thus prompted a renewed perspective on some of the more challenging components of the relocation transition. Study findings provide insight into how families organize individual and interpersonal narratives and use these narratives during transitional times. FLR can aid families in making a smoother and fulfilling move to an ALF and other late life transitions.

  15. The impact of an unconditional tax credit for families on self-rated health in adults: further evidence from the cohort study of 6900 New Zealanders.

    Science.gov (United States)

    Pega, Frank; Carter, Kristie; Kawachi, Ichiro; Davis, Peter; Blakely, Tony

    2014-05-01

    It is hypothesized that unconditional (given without obligation) publicly funded financial credits more effectively improve health than conditional financial credits in high-income countries. We previously reported no discernible short-term impact of an employment-conditional tax credit for families on self-rated health (SRH) in adults in New Zealand. This study estimates the effect of an unconditional tax credit for families, called Family Tax Credit (FTC), on SRH in the same study population and setting. A balanced panel of 6900 adults in families was extracted from seven waves (2002-2009) of the Survey of Family, Income and Employment. The exposures, eligibility for and amount of FTC, were derived by applying government eligibility and entitlement criteria. The outcome, SRH, was collected annually. Fixed effects regression analyses eliminated all time-invariant confounding and adjusted for measured time-varying confounders. Becoming eligible for FTC was associated with a small and statistically insignificant change in SRH over the past year [effect estimate: 0.013; 95% confidence interval (CI) -0.011 to 0.037], as was an increase in the estimated amount of FTC by $1000 (effect estimate: -0.001; 95% CI -0.006 to 0.004). The unconditional tax credit for families had no discernible short-term impact on SRH in adults in New Zealand. It did not more effectively improve health status than an employment-conditional tax credit for families. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Ways of Improving the Training of Interns Pediatricians and General Practitioners — Family Physicians in «Pediatrics» Discipline

    Directory of Open Access Journals (Sweden)

    S.A. Mokiia-Serbina

    2015-09-01

    Full Text Available Graduates of medical schools having sufficient theoretical and practical skills often have difficulty in communicating with patients — children and their parents, as well as with colleagues. Objective: improving the efficiency of the educational process in the training of interns pediatricians and general practitioners — family physicians in «Pediatrics» course. Methods of the study: theoretical analysis of gathered experience. Results and discussion. During internship at the department, there are used seminars-discussions, seminars — training conferences, seminars — round tables that allows you to work out the tactics of speech, methods of discussion, reasoning of judgments, review, assessment, analysis. Interns most of the time must participate in the examination of a sick child, discussions of the results, conversations with parents. Clinical analysis of patients should be carried out using the method of structured group discussion when each intern can express his views. Interns are involved in scientific work, speak at scientific conferences. The department created a series of ambulatory pediatrics, -during which the intern talks to a child, his parents and he must to conciliate them, to inspire confidence and to prove himself as a specialist. During this course, special attention is paid to the psychological component of medical trai-ning. Clas-ses are conducted by assistant pediatrician, a graduate majoring in «Practical Psychology». Conclusions. The use of interactive teaching methods at different stages of the educational process contributes not only to improvement of theoretical activity, but also the formation in interns of professional qualities of clinical and scientific thinking, competence in the construction and development of interpersonal relations, humanism.

  17. In pursuit of sisterhood: adult siblings as a resource for combined individual and family therapy.

    Science.gov (United States)

    Kahn, M D; Bank, S

    1981-03-01

    Therapists traditionally view brothers and sisters as rivalrous and self-seeking. Under carefully arranged conditions, however, siblings can learn to cooperate with each other to resolve important conflicts in family relationships. This case documents a dramatic change in the relationship between a 29-year-old woman and her father, the outcome of a three-step therapeutic intervention in which sibling dynamics were selectively used by the psychotherapist. As part of her individual therapy, the therapist first aroused the woman's discontent with her status as the neglected "baby of the family." Next, a series of meetings were held with the woman and her three sisters that permitted resolution of their previous anger and misunderstandings, thus helping them to become a more cohesive group of sisters. The third step brought the sisters, now as allies both of the identified patient and of the therapist, into a constructive confrontation with the parents. This resulted in lasting personal change for the identified patient and improved relationships throughout the entire family.

  18. How Philip Morris built Marlboro into a global brand for young adults: implications for international tobacco control.

    Science.gov (United States)

    Hafez, N; Ling, P M

    2005-08-01

    To describe Philip Morris' global market research and international promotional strategies targeting young adults. Analysis of previously secret tobacco industry documents. Philip Morris pursued standardised market research and strategic marketing plans in different regions throughout the world using research on young adults with three principle foci: lifestyle/psychographic research, brand studies, and advertising/communication effectiveness. Philip Morris identified core similarities in the lifestyles and needs of young consumers worldwide, such as independence, hedonism, freedom, and comfort. In the early 1990s Philip Morris adopted standardised global marketing efforts, creating a central advertising production bank and guidelines for brand images and promotions, but allowing regional managers to create regionally appropriate individual advertisements. Values and lifestyles play a central role in the global marketing of tobacco to young adults. Worldwide counter marketing initiatives, coupled with strong, coherent global marketing policies such as the Framework Convention on Tobacco Control, are needed to break associations between young adult values and tobacco brands. As globalisation promotes the homogenisation of values and lifestyles, tobacco control messages that resonate with young adults in one part of the world may appeal to young adults in other countries. Successful tobacco control messages that appeal to young people, such as industry denormalisation, may be expanded globally with appropriate tailoring to appeal to regional values.

  19. Child Internalizing Symptoms: Contributions of Child Temperament, Maternal Negative Affect, and Family Functioning

    Science.gov (United States)

    Crawford, Nicole A.; Schrock, Matthew; Woodruff-Borden, Janet

    2011-01-01

    Research has traditionally focused on the role of genetic and environmental variables in the development and maintenance of childhood internalizing disorders. Temperament variables, such as negative affect and effortful control have gained considerable interest within the field of developmental psychopathology. Environmental factors such as…

  20. Neuropsychological Performance and Family History in Children at Age 7 who Develop Adult Schizophrenia or Bipolar Psychosis in the New England Family Studies

    Science.gov (United States)

    Seidman, Larry J.; Cherkerzian, Sara; Goldstein, Jill M.; Agnew-Blais, Jessica; Tsuang, Ming T.; Buka, Stephen L.

    2013-01-01

    Objective Persons developing schizophrenia (SCZ) manifest various premorbid neuropsychological deficits, studied most often by measures of IQ. Far less is known about premorbid neuropsychological functioning in individuals who later develop bipolar psychoses (BP). We evaluated the specificity and impact of family history (FH) of psychosis on premorbid neuropsychological functioning. Methods We conducted a nested case-control study investigating the associations of neuropsychological data systematically collected at age 7 years for 99 adults with psychotic diagnoses (including 45 SCZ and 35 BP) and 101 controls, drawn from the New England cohort of the Collaborative Perinatal Project. A mixed model approach evaluated Full Scale IQ, four neuropsychological factors derived from principal components analysis, and the profile of 10 intelligence and achievement tests, controlling for maternal education, race, and intrafamilial correlation. We used a deviant responder approach (neuropsychologically impaired. Presence of psychosis in first-degree relatives (FH+) significantly increased the severity of childhood impairment for SCZ but not for BP. Conclusions Premorbid neuropsychological deficits are found in a substantial proportion of children who later develop SCZ, especially in the SCZ FH+ subgroup, but less so in BP, suggesting especially impaired neurodevelopment underlying cognition in pre-SCZ children. Future work should assess genetic and environmental factors that explain this FH effect. PMID:22575089

  1. About one-half of adults with active epilepsy and seizures have annual family incomes under $25,000: The 2010 and 2013 US National Health Interview Surveys.

    Science.gov (United States)

    Us Centers For Disease Control And Prevention Epilepsy Program

    2016-05-01

    People with active epilepsy are those who reported being told that they have epilepsy or a seizure disorder and either take antiseizure medication or have had a seizure during the past 12months. We used combined 2010 and 2013 National Health Interview Survey (NHIS) data on US adults with active epilepsy to examine whether taking medications and seizure frequency differed by sex, age, race/ethnicity, and reported or imputed annual family income. Of adults with active epilepsy, 45.5% reported taking medication and having at least one seizure, 41.3% reported taking medication and having no seizures, and 13.2% reported not taking any medication and having at least one seizure. About one-half of adults with active epilepsy and seizures have annual family incomes of less than $25,000. Promoting self-management supports and improved access to specialty care may reduce the burden of uncontrolled seizures in adults with epilepsy. Published by Elsevier Inc.

  2. Lifestyle, cardiovascular drugs and risk factors in younger and elder adults: The PEP family heart study

    Directory of Open Access Journals (Sweden)

    Peter Schwandt

    2010-01-01

    Full Text Available Objectives: This study aimed to compare cardiovascular disease (CVD risk factors, lifestyle habits and pharmacological treatment in two groups of elder adults with 20 years difference in their mean age. Methods: This study comprised 590 women including two groups with mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of two groups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data on physical examination, fasting blood analyses, 7-day dietary re-cords, physical activity, smoking and actual medication use were recorded. Results: Compared with younger individuals, seniors had a more adverse risk factor profile in terms of abdominal obesity, over-weight, hyperglycemia, hypertension, dyslipoproteinemia without differences in HDL-C. But this is not reflected by lifestyle behav-ior. Less than 2% of the elderly and 17% of the younger adults were current smoker. Furthermore, the pattern of physical activ-ity was different in terms of more continuous sports in seniors contrasting with extremes between no sports and more than twice a week in the younger group. Seniors consumed significantly less carbohydrates including more monosaccharide and less polysaccharides, more alcohol and water. The intake of fat and protein was higher in elder women than in all other groups. One third of seniors took antihypertensive medications and 12% used lipid modifying drugs. Conclusions: Different levels of prevention against CVDs and their risk factors shall be considered for various age groups of population. The findings of this study emphasize on the necessity of preventive measures against smoking and physical inactivity in younger adults and dietary habits in seniors.

  3. End-of-Year 2009-10 Progress Report to the California Legislature: Implementation and Impact of the Workforce Investment Act (WIA), Title II Adult Education and Family Literacy Act

    Science.gov (United States)

    CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2011

    2011-01-01

    The Federal Workforce Investment Act (WIA), Title II: Adult Education and Family Literacy Act (AEFLA) provide funding for states and territories to provide instruction in English as a Second Language (ESL), Adult Basic Education (ABE), and Adult Secondary Education (ASE) to adults in need of these literacy services. California State Budget Act…

  4. Perceived functioning and disability in adults with myotonic dystrophy type 1: a survey according to the International Classification Of Functioning, Disability and Health.

    Science.gov (United States)

    Kierkegaard, Marie; Harms-Ringdahl, Karin; Widén Holmqvist, Lotta; Tollbäck, Anna

    2009-06-01

    The purpose of this study was to describe and analyse self-rated perceived functioning, disability and environmental facilitators/barriers with regard to disease severity, using the International Classification of Functioning, Disability and Health (ICF) checklist, in adults with myotonic dystrophy type 1. Cross-sectional design. Forty-one women and 29 men with myotonic dystrophy type 1. A modified ICF checklist was used for self-rating of perceived problems in 29 body-function categories, difficulties in 52 activity and participation categories, and facilitators/barriers in 23 environmental-factor categories according to the verbal anchors of the ICF qualifiers. Disease severity classification was based on the muscular impairment rating scale. Of the persons with myotonic dystrophy type 1, 80% perceived problems of excessive daytime sleepiness, 76% of muscle power, and 66% of energy and drive functions, while over 59% perceived difficulties in physically demanding mobility activities. Disabilities in mobility, self-care and domestic life were more frequently reported by persons with severe disease. Support from the immediate family, medicines and social security services were perceived as facilitators for 50-60% of the participants. Disabilities and important environmental facilitators in adults with myotonic dystrophy type 1 were identified, and this clinically-relevant information can be used for developing health services for people with this condition.

  5. Colonoscopy screening among US adults aged 40 or older with a family history of colorectal cancer.

    Science.gov (United States)

    Tsai, Meng-Han; Xirasagar, Sudha; Li, Yi-Jhen; de Groen, Piet C

    2015-05-21

    Colonoscopy screening reduces colorectal cancer (CRC) incidence and mortality. CRC screening is recommended at age 50 for average-risk people. Screening of first-degree relatives of CRC patients is recommended to begin at age 40 or 10 years before the age at diagnosis of the youngest relative diagnosed with CRC. CRC incidence has increased recently among younger Americans while it has declined among older Americans. The objective of this study was to determine whether first-degree relatives of CRC patients are being screened according to recommended guidelines. We studied colonoscopy screening rates among the US population reporting a CRC family history using 2005 and 2010 National Health Interview Survey data. Of 26,064 study-eligible respondents, 2,470 reported a CRC family history; of those with a family history, 45.6% had a colonoscopy (25.2% in 2005 and 65.8% 2010). The colonoscopy rate among first-degree relatives aged 40 to 49 in 2010 (38.3%) was about half that of first-degree relatives aged 50 or older (69.7%). First-degree relatives were nearly twice as likely as nonfirst-degree relatives to have a colonoscopy (adjusted odds ratio [AOR], 1.7; 95% confidence interval, 1.5-1.9), but those aged 40 to 49 were less likely to have a colonoscopy than those in older age groups (AOR, 2.6 for age 50-64; AOR, 3.6 for age ≥65). Interactions with age, insurance, and race/ethnicity were not significant. Having health insurance tripled the likelihood of screening. Despite a 5-fold increase in colonoscopy screening rates since 2005, rates among first-degree relatives younger than the conventional screening age have lagged. Screening promotion targeted to this group may halt the recent rising trend of CRC among younger Americans.

  6. Design of the Familial Hypercholesterolaemia Australasia Network Registry: Creating Opportunities for Greater International Collaboration.

    Science.gov (United States)

    Bellgard, Matthew I; Walker, Caroline E; Napier, Kathryn R; Lamont, Leanne; Hunter, Adam A; Render, Lee; Radochonski, Maciej; Pang, Jing; Pedrotti, Annette; Sullivan, David R; Kostner, Karam; Bishop, Warrick; George, Peter M; O'Brien, Richard C; Clifton, Peter M; Bockxmeer, Frank M Van; Nicholls, Stephen J; Hamilton-Craig, Ian; Dawkins, Hugh Js; Watts, Gerald F

    2017-10-01

    Familial Hypercholesterolemia (FH) is the most common and serious monogenic disorder of lipoprotein metabolism that leads to premature coronary heart disease. There are over 65,000 people estimated to have FH in Australia, but many remain undiagnosed. Patients with FH are often under-treated, but with early detection, cascade family testing and adequate treatment, patient outcomes can improve. Patient registries are key tools for providing new information on FH and enhancing care worldwide. The development and design of the FH Australasia Network Registry is a crucial component in the comprehensive model of care for FH, which aims to provide a standardized, high-quality and cost-effective system of care that is likely to have the highest impact on patient outcomes. Informed by stakeholder engagement, the FH Australasia Network Registry was collaboratively developed by government, patient and clinical networks and research groups. The open-source, web-based Rare Disease Registry Framework was the architecture chosen for this registry owing to its open-source standards, modular design, interoperability, scalability and security features; all these are key components required to meet the ever changing clinical demands across regions. This paper provides a high level blueprint for other countries and jurisdictions to help inform and map out the critical features of an FH registry to meet their particular health system needs.

  7. Familial confounding of the association between maternal smoking during pregnancy and internalizing disorders in offspring

    DEFF Research Database (Denmark)

    Meier, S M; Plessen, K J; Verhulst, F

    2017-01-01

    Background Maternal smoking has consistently been associated with multiple adverse childhood outcomes including externalizing disorders. In contrast the association between maternal smoking during pregnancy (MSDP) and internalizing (anxiety and depressive) disorders in offspring has received less...... investigation. Method We conducted a nationwide cohort study including 957635 individuals born in Denmark between 1991 and 2007. Data on MSDP and diagnoses of depression or anxiety disorders were derived from national registers and patients were followed up from the age of 5 years to the end of 2012. Hazard...... severe depression [HRR 1.29, 95% confidence interval (CI) 1.22-1.36] and severe anxiety disorders (HRR 1.26, 95% CI 1.20-1.32) even when controlling for maternal and paternal traits. However, there was no association between MSDP and internalizing disorders when controlling for the mother's propensity...

  8. What drives Researchers´ Careers? The Role of International Mobility, Gender and Family

    OpenAIRE

    FERNANDEZ-ZUBIETA Ana; MARINELLI ELISABETTA; ELENA PÉREZ SUSANA

    2013-01-01

    International mobility has become increasingly common in the research profession, partly due to strong policy support. To understand this trend, it is necessary to explore how researchers plan and envisage their career, that is, what drives their decisions. In this exploratory paper we shed light on this issue, comparing career drivers across three mobility categories. Furthermore, we take into account gender and the parental status of the researchers, as both factors remarkably influence car...

  9. The predictive power of family history measures of alcohol and drug problems and internalizing disorders in a college population.

    Science.gov (United States)

    Kendler, Kenneth S; Edwards, Alexis; Myers, John; Cho, Seung Bin; Adkins, Amy; Dick, Danielle

    2015-07-01

    A family history (FH) of psychiatric and substance use problems is a potent risk factor for common internalizing and externalizing disorders. In a large web-based assessment of mental health in college students, we developed a brief set of screening questions for a FH of alcohol problems (AP), drug problems (DP) and depression-anxiety in four classes of relatives (father, mother, aunts/uncles/grandparents, and siblings) as reported by the student. Positive reports of a history of AP, DP, and depression-anxiety were substantially correlated within relatives. These FH measures predicted in the student, in an expected pattern, dimensions of personality and impulsivity, alcohol consumption and problems, smoking and nicotine dependence, use of illicit drugs, and symptoms of depression and anxiety. Using the mean score from the four classes of relatives was more predictive than using a familial/sporadic dichotomy. Interactions were seen between the FH of AP, DP, and depression-anxiety and peer deviance in predicting symptoms of alcohol and tobacco dependence. As the students aged, the FH of AP became a stronger predictor of alcohol problems. While we cannot directly assess the validity of these FH reports, the pattern of findings suggest that our brief screening items were able to assess, with some accuracy, the FH of substance misuse and internalizing psychiatric disorders in relatives. If correct, these measures can play an important role in the creation of developmental etiologic models for substance and internalizing psychiatric disorders which constitute one of the central goals of the overall project. © 2015 Wiley Periodicals, Inc.

  10. Psychological Support for Young Adults with Down Syndrome: Dohsa-Hou Program for Maladaptive Behaviors and Internalizing Problems

    Directory of Open Access Journals (Sweden)

    Haruo Fujino

    2017-09-01

    Full Text Available Psychological and psychiatric dysfunction is a major problem in a substantial proportion of young adults with Down syndrome. Some patients develop psychiatric issues, such as depressive, obsessive-compulsive, or psychotic-like disorders, in their late adolescence or young adulthood. Furthermore, these individuals may experience moderate to severe emotional and psychological distress. Development of a psychosocial treatment to address these issues is needed in addition to psychotropic medication. The current study reports two cases of young adults with Down syndrome, who presented psychiatric symptoms and marked disruption in their daily lives. These individuals participated in a Dohsa-hou treatment program. Following treatment, adaptive levels, maladaptive behaviors, and internalizing problems were evaluated by the Vineland Adaptive Behavior Scales-II. Participants showed improvement in maladaptive behaviors and internalizing problems; however, improvement in these areas may be influenced by baseline severity of the problems. This case report suggests that Dohsa-hou could be an effective therapeutic approach for maladaptive and internalizing problems in adults with Down syndrome.

  11. "My YAP Family": Analysis of a Facebook Group for Young Adults Living with HIV.

    Science.gov (United States)

    Gaysynsky, Anna; Romansky-Poulin, Kathryn; Arpadi, Stephen

    2015-06-01

    Little research exists regarding the use of social networking sites, like Facebook, for improving patient well-being. The aim of this study was to evaluate a private Facebook group established for members of an HIV clinic's young adult program. This study employed directed content analysis to examine the types and frequencies of interactions observable in the 3,838 posts and comments that appeared on the Facebook group page between March 1, 2011 and July 1, 2012. Analysis revealed that a large percentage (41.7 %) of the content was classified as "administrative/engagement in group" and functioned to enhance the operations of the program as a whole. Additionally, positive interactions were frequently observed, especially socializing (24.8 %), banter (20.2 %), and offers of social support (15.1 %). Emotional support was the most frequent type of support requested, while esteem support was the most commonly provided form of support. The results of this study demonstrate that a Facebook group can be a means of providing patients with social support and positive social interaction and can improve services for young adults with HIV.

  12. Family income, parental education and internalizing and externalizing psychopathology among 2-3-year-old Chinese children: the mediator effect of parent-child conflict.

    Science.gov (United States)

    Zhang, Xiao

    2014-02-01

    Using a sample of 156 Chinese children aged 2-3 years and their parents, this study examined the effects of socio-economic status, specifically family income and parental education, on the children's internalizing and externalizing psychopathology and whether these effects were mediated by mother-child and father-child conflict. Results indicated that family income, maternal education and paternal education all negatively predicted externalizing symptoms. Income also negatively predicted internalizing symptoms among boys but not girls. Maternal education negatively predicted internalizing symptoms among girls but not boys. The effects of income on psychopathology were fully mediated by mother-child and father-child conflict. In contrast, the effects of education were not mediated or only partially mediated by conflict. Findings are discussed in the framework of the family stress model. © 2013 International Union of Psychological Science.

  13. Executive Function and Internalizing Symptoms in Adolescents and Young Adults With Congenital Heart Disease: The Role of Coping.

    Science.gov (United States)

    Jackson, Jamie L; Gerardo, Gina M; Monti, Jennifer D; Schofield, Kyle A; Vannatta, Kathryn

    2018-01-10

    Executive functioning deficits have been documented among congenital heart disease (CHD) survivors and may contribute to emotional distress. Little research has investigated the role of coping in this association. This study examined the role of coping in accounting for the association between self-reported executive function problems and internalizing symptoms among adolescents and emerging adults (AEAs), as well as young adults (YAs) with CHD. Participants included 74 AEA ( M age  = 19.32  ±  3.47 years, range 15-25 years) and 98 YA CHD survivors ( M age  = 32.00  ±  3.69 years, range 26-39 years), recruited from pediatric and adult outpatient cardiology clinics. Participants completed self-report measures of executive function problems, coping (primary control, secondary control, and disengagement coping), and internalizing symptoms. Lesion severity classification and functional impairment due to symptoms of heart failure were determined from medical chart review. Significant problems in executive function were reported by 5% of AEA and 13% of YA. Coping was not associated with executive function problems or internalizing symptoms for AEA. However, among YA, less use of adaptive coping strategies and more maladaptive coping responses was associated with both more executive function problems and internalizing symptoms. An indirect effect of executive function problems on internalizing symptoms via secondary control coping emerged for YA. Executive function problems may disrupt the ability to use important adaptive coping skills, such as cognitive reappraisal, positive thinking, and acceptance, thereby resulting in greater emotional distress among YA CHD survivors. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. Family Conflict, Mood, and Adolescents’ Daily School Problems: Moderating Roles of Internalizing and Externalizing Symptoms

    Science.gov (United States)

    Timmons, Adela C.; Margolin, Gayla

    2014-01-01

    Using daily diary data, this study examined cross-day associations between family conflict and school problems and tested mediating effects of daily negative mood and moderating effects of psychological symptoms. For 2 weeks, parents and adolescents (N = 106; mean age = 15.4) reported daily conflict; adolescents reported daily negative mood and school problems. Results indicated bidirectional, multi-day spillover between parent-adolescent conflict and school problems with daily negative mood statistically accounting for spillover both within and across days. Externalizing symptoms strengthened links between father-adolescent conflict and school problems, whereas depressive and anxious symptoms strengthened links between parent-adolescent conflict and daily negative mood. By demonstrating cross-domain transmission of daily problems, these findings highlight the salience of everyday events as possible intervention targets. PMID:25346538

  15. Family conflict, mood, and adolescents' daily school problems: moderating roles of internalizing and externalizing symptoms.

    Science.gov (United States)

    Timmons, Adela C; Margolin, Gayla

    2015-01-01

    Using daily diary data, this study examined cross-day associations between family conflict and school problems and tested mediating effects of daily negative mood and moderating effects of psychological symptoms. For 2 weeks, parents and adolescents (N = 106; Mage = 15.4) reported daily conflict; adolescents reported daily negative mood and school problems. Results indicated bidirectional, multiday spillover between parent-adolescent conflict and school problems with daily negative mood statistically accounting for spillover both within and across days. Externalizing symptoms strengthened links between father-adolescent conflict and school problems, whereas depressive and anxious symptoms strengthened links between parent-adolescent conflict and daily negative mood. By demonstrating cross-domain transmission of daily problems, these findings highlight the salience of everyday events as possible intervention targets. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

  16. White matter structure in young adults with familial risk for psychosis - The Oulu Brain and Mind Study.

    Science.gov (United States)

    Koivukangas, Jenni; Björnholm, Lassi; Tervonen, Osmo; Miettunen, Jouko; Nordström, Tanja; Kiviniemi, Vesa; Mäki, Pirjo; Jääskeläinen, Erika; Mukkala, Sari; Moilanen, Irma; Barnett, Jennifer H; Jones, Peter B; Nikkinen, Juha; Veijola, Juha

    2015-09-30

    According to the disconnectivity model, disruptions in neural connectivity play an essential role in the pathology of schizophrenia. The aim of this study was to determine whether these abnormalities are present in young adults with familial risk (FR) for psychosis in the general population based sample. We used diffusion tensor imaging (DTI) and tract-based spatial statistics to compare whole-brain fractional anisotropy, mean diffusivity, and axial and radial diffusion in 47 (17 males) FR subjects to 51 controls (17 males). All the participants were aged between 20 and 25 years and were members of the Northern Finland Birth Cohort 1986 (Oulu Brain and Mind Study). Region of interest analyses were conducted for 12 tracts. Separately, we analysed whole-brain FA for the subgroup with FR for schizophrenia (n=13) compared with 13 gender-matched controls. Contrary to our expectations there were no differences in any of the DTI measures between FR and control groups. This suggests that white matter abnormalities may not be a genetic feature for risk of psychosis and preceding the onset of a psychotic disorder. Our findings do not support the theory of disconnectivity as a primary sign of psychosis in young adults with FR for the illness. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. The Virtual Family-development of surface-based anatomical models of two adults and two children for dosimetric simulations

    Energy Technology Data Exchange (ETDEWEB)

    Christ, Andreas; Honegger, Katharina; Zefferer, Marcel; Neufeld, Esra; Oberle, Michael; Szczerba, Dominik; Kuster, Niels [Foundation for Research on Information Technologies in Society (IT' IS), Zeughausstr. 43, 8004 Zuerich (Switzerland); Kainz, Wolfgang; Guag, Joshua W [US Food and Drug Administration (FDA), Center for Devices and Radiological Health (CDRH), Silver Spring, MD 20993 (United States); Hahn, Eckhart G; Rascher, Wolfgang; Janka, Rolf; Bautz, Werner [Universitaetsklinikum Erlangen, Friedrich-Alexander Universitaet Erlangen-Nuernberg, 91054 Erlangen (Germany); Chen, Ji; Shen, Jianxiang [Department of Electrical and Computer Engineering, The University of Houston, Houston, TX 77204 (United States); Kiefer, Berthold; Schmitt, Peter; Hollenbach, Hans-Peter [Siemens Healthcare, MR-Application Development, 91052 Erlangen (Germany); Kam, Anthony [Department of Imaging, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224 (United States)], E-mail: christ@itis.ethz.ch

    2010-01-21

    The objective of this study was to develop anatomically correct whole body human models of an adult male (34 years old), an adult female (26 years old) and two children (an 11-year-old girl and a six-year-old boy) for the optimized evaluation of electromagnetic exposure. These four models are referred to as the Virtual Family. They are based on high resolution magnetic resonance (MR) images of healthy volunteers. More than 80 different tissue types were distinguished during the segmentation. To improve the accuracy and the effectiveness of the segmentation, a novel semi-automated tool was used to analyze and segment the data. All tissues and organs were reconstructed as three-dimensional (3D) unstructured triangulated surface objects, yielding high precision images of individual features of the body. This greatly enhances the meshing flexibility and the accuracy with respect to thin tissue layers and small organs in comparison with the traditional voxel-based representation of anatomical models. Conformal computational techniques were also applied. The techniques and tools developed in this study can be used to more effectively develop future models and further improve the accuracy of the models for various applications. For research purposes, the four models are provided for free to the scientific community. (note)

  18. The Virtual Family-development of surface-based anatomical models of two adults and two children for dosimetric simulations

    International Nuclear Information System (INIS)

    Christ, Andreas; Honegger, Katharina; Zefferer, Marcel; Neufeld, Esra; Oberle, Michael; Szczerba, Dominik; Kuster, Niels; Kainz, Wolfgang; Guag, Joshua W; Hahn, Eckhart G; Rascher, Wolfgang; Janka, Rolf; Bautz, Werner; Chen, Ji; Shen, Jianxiang; Kiefer, Berthold; Schmitt, Peter; Hollenbach, Hans-Peter; Kam, Anthony

    2010-01-01

    The objective of this study was to develop anatomically correct whole body human models of an adult male (34 years old), an adult female (26 years old) and two children (an 11-year-old girl and a six-year-old boy) for the optimized evaluation of electromagnetic exposure. These four models are referred to as the Virtual Family. They are based on high resolution magnetic resonance (MR) images of healthy volunteers. More than 80 different tissue types were distinguished during the segmentation. To improve the accuracy and the effectiveness of the segmentation, a novel semi-automated tool was used to analyze and segment the data. All tissues and organs were reconstructed as three-dimensional (3D) unstructured triangulated surface objects, yielding high precision images of individual features of the body. This greatly enhances the meshing flexibility and the accuracy with respect to thin tissue layers and small organs in comparison with the traditional voxel-based representation of anatomical models. Conformal computational techniques were also applied. The techniques and tools developed in this study can be used to more effectively develop future models and further improve the accuracy of the models for various applications. For research purposes, the four models are provided for free to the scientific community. (note)

  19. Clinical and neuroradiological study on adult cases of familial microcephaly associated with mental retardation and convulsive seizure

    International Nuclear Information System (INIS)

    Murakami, Nobuyuki; Kitabayashi, Toshiko.

    1987-01-01

    Microcephaly results from various causes, some genetic and some non-genetic. Recently, we encountered two families with microcephaly, mental retardation and convulsive seizure. These conform to an autosomal recessive mode of inheritance. All adult cases were analyzed to describe the characteristic neuroradiographic findings. Although each presented a similar neurologic outlook, two cases secondarily resulting from infection or injuries to the developing brain during postnatal periods showed a specific variation. Skull X-P and CT scan of these two cases showed thickening of the carvarium, predominantly fronto-parietal lobe atrophy of the cerebrum, enlargement of the ventricle, and compensatory hypertrophy of sinuses. Magnetic resonance imaging (MRI) showed severe micropolygyria and hypogenesis of corpus callosum. Abnormalities such as skull X-P, CT scan and MRI were severer in the secondary than in the primary microcephalics. Although brain volume was reduced, the volume ratio of cortex to white watter was similar to that of normal brain. MRI on severe cases of microcephaly revealed a high signal intensity in inversion-recovery images on the brain stem where markedly atrophy was noted. In adult microcephaly, the extent of cerebral development was thought to be reflected in the corpus callosum and brain stem where neuron fibers were densely gathered. (author)

  20. Internationally Adopted Children from Non-European Countries: General Development during the First Two Years in the Adoptive Family

    Directory of Open Access Journals (Sweden)

    Monica Dalen

    2012-01-01

    Full Text Available Internationally adopted children are often delayed in their development and demonstrate more behaviour problems than nonadopted children due to adverse preadoption circumstances. This is especially true for children adopted from Eastern European countries. Few studies have focused on children adopted from non-European countries. This paper presents results from an ongoing longitudinal study of 119 internationally adopted children from non-European countries during their first two years in Norway. Several scales measuring different aspects of the children’s development are included in the study: communication and gross motor development, temperamental characteristics, and behaviour problems. The results show that internationally adopted children are delayed in their general development when they first arrive in their adoptive families. After two years the children have made significant progress in development. However, they still lag behind in communication and motor skills compared to non-adopted children. The temperamental characteristics seem very stable from time of adoption until two years after adoption. The children demonstrate a low frequency of behaviour problems. However, the behaviour problems have changed during the two years. At time of adoption they show more nonphysically challenging behaviour while after two years their physically challenging behaviour has increased.

  1. Internationally adopted children from non-European countries: general development during the first two years in the adoptive family.

    Science.gov (United States)

    Dalen, Monica; Theie, Steinar

    2012-01-01

    Internationally adopted children are often delayed in their development and demonstrate more behaviour problems than nonadopted children due to adverse preadoption circumstances. This is especially true for children adopted from Eastern European countries. Few studies have focused on children adopted from non-European countries. This paper presents results from an ongoing longitudinal study of 119 internationally adopted children from non-European countries during their first two years in Norway. Several scales measuring different aspects of the children's development are included in the study: communication and gross motor development, temperamental characteristics, and behaviour problems. The results show that internationally adopted children are delayed in their general development when they first arrive in their adoptive families. After two years the children have made significant progress in development. However, they still lag behind in communication and motor skills compared to non-adopted children. The temperamental characteristics seem very stable from time of adoption until two years after adoption. The children demonstrate a low frequency of behaviour problems. However, the behaviour problems have changed during the two years. At time of adoption they show more nonphysically challenging behaviour while after two years their physically challenging behaviour has increased.

  2. Pathways involving traumatic losses, worry about family, adult separation anxiety and posttraumatic stress symptoms amongst refugees from West Papua.

    Science.gov (United States)

    Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick

    2015-10-01

    There is some evidence that adult separation anxiety disorder (ASAD) symptoms are closely associated with posttraumatic stress disorder (PTSD) amongst refugees exposed to traumatic events (TEs), but the pathways involved remain to be elucidated. A recent study suggests that separation anxiety disorder precedes and predicts onset of PTSD. We examined a path model testing whether ASAD symptoms and worry about family mediated the path from traumatic losses to PTSD symptoms amongst 230 refugees from West Papua. Culturally adapted measures were applied to assess TE exposure and symptoms of ASAD and PTSD. A structural equation model indicated that ASAD symptoms played an important role in mediating the effects of traumatic losses and worry about family in the pathway to PTSD symptoms. Although based on cross-sectional data, our findings suggest that ASAD symptoms may play a role in the path from traumatic losses to PTSD amongst refugees. We propose an evolutionary model in which the ASAD and PTSD reactions represent complementary survival responses designed to protect the individual and close attachments from external threats. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Early-life school, neighborhood, and family influences on adult health: a multilevel cross-classified analysis of the Aberdeen children of the 1950s study.

    Science.gov (United States)

    Dundas, Ruth; Leyland, Alastair H; Macintyre, Sally

    2014-07-15

    Lifetime exposures to adverse social environments influence adult health, as do exposures in early life. It is usual to examine the influences of school on teenage health and of adult area of residence on adult health. We examined the combined long-term association of the school attended, as well as the area of residence in childhood, with adult health. A total of 6,285 children from Aberdeen, Scotland, who were aged 5-12 years in 1962, were followed up at a mean age of 47 years in 2001. Cross-classified multilevel logistic regression was used to estimate the associations of family, school, and area of residence with self-reported adult health and mental health, adjusting for childhood family-, school-, and neighborhood-level factors, as well as current adult occupational position. Low early-life social position (as determined by the father's occupational level) was associated with poor adult self-rated health but not poor mental health. There were small contextual associations between childhood school environment (median odds ratio = 1.08) and neighborhood environment (median odds ratio = 1.05) and adult self-rated health. The share of the total variance in health at the family level was 10.1% compared with 89.6% at the individual level. Both socioeconomic context and composition in early life appear to have an influence on adult health, even after adjustment for current occupational position. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

  4. The familial dysautonomia disease gene IKBKAP is required in the developing and adult mouse central nervous system

    Directory of Open Access Journals (Sweden)

    Marta Chaverra

    2017-05-01

    Full Text Available Hereditary sensory and autonomic neuropathies (HSANs are a genetically and clinically diverse group of disorders defined by peripheral nervous system (PNS dysfunction. HSAN type III, known as familial dysautonomia (FD, results from a single base mutation in the gene IKBKAP that encodes a scaffolding unit (ELP1 for a multi-subunit complex known as Elongator. Since mutations in other Elongator subunits (ELP2 to ELP4 are associated with central nervous system (CNS disorders, the goal of this study was to investigate a potential requirement for Ikbkap in the CNS of mice. The sensory and autonomic pathophysiology of FD is fatal, with the majority of patients dying by age 40. While signs and pathology of FD have been noted in the CNS, the clinical and research focus has been on the sensory and autonomic dysfunction, and no genetic model studies have investigated the requirement for Ikbkap in the CNS. Here, we report, using a novel mouse line in which Ikbkap is deleted solely in the nervous system, that not only is Ikbkap widely expressed in the embryonic and adult CNS, but its deletion perturbs both the development of cortical neurons and their survival in adulthood. Primary cilia in embryonic cortical apical progenitors and motile cilia in adult ependymal cells are reduced in number and disorganized. Furthermore, we report that, in the adult CNS, both autonomic and non-autonomic neuronal populations require Ikbkap for survival, including spinal motor and cortical neurons. In addition, the mice developed kyphoscoliosis, an FD hallmark, indicating its neuropathic etiology. Ultimately, these perturbations manifest in a developmental and progressive neurodegenerative condition that includes impairments in learning and memory. Collectively, these data reveal an essential function for Ikbkap that extends beyond the peripheral nervous system to CNS development and function. With the identification of discrete CNS cell types and structures that depend on

  5. Association of Filial Responsibility, Ethnicity, and Acculturation Among Japanese American Family Caregivers of Older Adults.

    Science.gov (United States)

    Miyawaki, Christina E

    2017-03-01

    Challenges of filial caregiving practices by 1st-generation immigrants due to differences in caregiving values between their home and host countries are well documented. This study explored the filial responsibility of later generation Japanese American caregivers of older adults. Acculturation and filial responsibility were measured using the Suinn-Lew Asian Self Identity Acculturation scale and Filial Values Index, respectively. A qualitative interview guide was developed using Gordon's assimilation theory, and 21 caregivers ( M age = 68 years, 86% female, seven in each generation) were interviewed. Despite the 3rd-generation caregivers' high acculturation level, their filial responsibility scores remained high. Qualitative interviews also revealed later generation caregivers' strong filial responsibility and continued caregiving involvement. Unexpectedly, caregivers' own future expectancy of care included placement in mainstream residential facilities rather than ethnic-specific settings. Findings point to the need to develop caregiver services that consider later generation caregivers' culture and level of assimilation.

  6. Lifestyle, Cardiovascular Drugs and Risk Factors in Younger and Elder Adults: The PEP Family Heart Study

    Directory of Open Access Journals (Sweden)

    Peter Schwandt

    2010-01-01

    Full Text Available Objectives: This study aimed to compare cardiovascular disease(CVD risk factors, lifestyle habits and pharmacological treatmentin two groups of elder adults with 20 years difference in theirmean age.Methods: This study comprised 590 women including two groupswith mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of twogroups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data onphysical examination, fasting blood analyses, 7-day dietary records,physical activity, smoking and actual medication use wererecorded.Results: Compared with younger individuals, seniors had a moreadverse risk factor profile in terms of abdominal obesity, overweight,hyperglycemia, hypertension, dyslipoproteinemia withoutdifferences in HDL-C. But this is not reflected by lifestyle behavior.Less than 2% of the elderly and 17% of the younger adultswere current smoker. Furthermore, the pattern of physical activitywas different in terms of more continuous sports in seniorscontrasting with extremes between no sports and more than twicea week in the younger group. Seniors consumed significantly lesscarbohydrates including more monosaccharide and less polysaccharides,more alcohol and water. The intake of fat and proteinwas higher in elder women than in all other groups. One third ofseniors took antihypertensive medications and 12% used lipidmodifying drugs.Conclusions: Different levels of prevention against CVDs andtheir risk factors shall be considered for various age groups ofpopulation. The findings of this study emphasize on the necessityof preventive measures against smoking and physical inactivity inyounger adults and dietary habits in seniors.

  7. WHAT DRIVES RESEARCHERS' CAREERS? THE ROLE OF INTERNATIONAL MOBILITY, GENDER AND FAMILY

    Directory of Open Access Journals (Sweden)

    Ana Fernandez-Zubieta

    2014-07-01

    Full Text Available International mobility has become increasingly common in the research profession, partly due to strong policy support. To understand this trend, it is necessary to explore how researchers plan and envisage their career, that is, what drives their decisions. In this exploratory paper we shed light on this issue, comparing career drivers across three mobility categories. Furthermore, we take into account gender and the parental status of the researchers, as both factors remarkably influence career choices. We use data from the Study on International Mobility and Researchers’ Career Development Project (SIM-ReC, launched in 2011 by the Institute of Prospective Technological Studies (IPTS in collaboration with NIFU (Norway, Logotech (Greece and the University of Athens. The dataset covers researchers working in European universities across ten countries: Belgium, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden, Switzerland and the UK. The results highlight how different mobility patterns reflect different motivations and confirm that gender and parenthood are critical in shaping career decisions

  8. WHAT DRIVES RESEARCHERS' CAREERS? THE ROLE OF INTERNATIONAL MOBILITY, GENDER AND FAMILY

    Directory of Open Access Journals (Sweden)

    Ana Fernandez-Zubieta

    2013-10-01

    Full Text Available International mobility has become increasingly common in the research profession, partly due to strong policy support. To understand this trend, it is necessary to explore how researchers plan and envisage their career, that is, what drives their decisions. In this exploratory paper we shed light on this issue, comparing career drivers across three mobility categories. Furthermore, we take into account gender and the parental status of the researchers, as both factors remarkably influence career choices. We use data from the Study on International Mobility and Researchers’ Career Development Project (SIM-ReC, launched in 2011 by the Institute of Prospective Technological Studies (IPTS in collaboration with NIFU (Norway, Logotech (Greece and the University of Athens. The dataset covers researchers working in European universities across ten countries: Belgium, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden, Switzerland and the UK. The results highlight how different mobility patterns reflect different motivations and confirm that gender and parenthood are critical in shaping career decisions.

  9. "Let him speak:" a descriptive qualitative study of the roles and behaviors of family companions in primary care visits among older adults with cognitive impairment.

    Science.gov (United States)

    Vick, Judith B; Amjad, Halima; Smith, Katherine C; Boyd, Cynthia M; Gitlin, Laura N; Roth, David L; Roter, Debra L; Wolff, Jennifer L

    2018-01-01

    Cognitive impairment poses communication challenges in primary care. Although family "companions" commonly attend primary care visits of older adults with cognitive impairment, little is known about how their involvement affects communication. Therefore, we sought to understand how companion involvement affects the quality of primary care visit communication for older adults with cognitive impairment. Cross-sectional, descriptive qualitative study participants were as follows: (1) English-speaking adults age 65 or older with mild, moderate, or severe cognitive impairment; (2) family members or other unpaid companions who accompany older adults to primary care visits; and (3) primary care clinicians. Twenty semi-structured and in-depth qualitative interviews of older adults and their companions (N = 20 dyads) and two focus groups (N = 10 primary care clinicians) were conducted. Interviews and focus groups were transcribed and analyzed thematically. Family companions commonly facilitate communication by advocating for patients, ensuring the accuracy of information exchange and understanding, and preserving rapport. Significant communication challenges were also identified, including patient and companion role ambiguity, competing visit agendas, and primary care clinician confusion regarding the most accurate source of information. Patients, companions, and clinicians each identified strategies to improve communication, chief among them being to identify, differentiate, and respect both patient and companion priorities and perspectives. Family companions actively participate in primary care visits of older adults with cognitive impairment in ways that promote and inhibit effective communication. Findings suggest the need for strategies that more effectively and purposefully involve family in the care of primary care patients with cognitive impairment. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  10. Analysis of Adult Female Mouse (Mus musculus) Group Behavior on the International Space Station (ISS)

    Science.gov (United States)

    Solomides, P.; Moyer, E. L.; Talyansky, Y.; Choi, S.; Gong, C.; Globus, R. K.; Ronca, A. E.

    2016-01-01

    As interest in long duration effects of space habitation increases, understanding the behavior of model organisms living within the habitats engineered to fly them is vital for designing, validating, and interpreting future spaceflight studies. A handful of papers have previously reported behavior of mice and rats in the weightless environment of space. The Rodent Research Hardware and Operations Validation (Rodent Research-1; RR1) utilized the Rodent Habitat (RH) developed at NASA Ames Research Center to fly mice on the ISS (International Space Station). Ten adult (16-week-old) female C57BL/6 mice were launched on September 21st, 2014 in an unmanned Dragon Capsule, and spent 37 days in microgravity. Here we report group behavioral phenotypes of the RR1 Flight (FLT) and environment-matched Ground Control (GC) mice in the Rodent Habitat (RH) during this long-duration flight. Video was recorded for 33 days on the ISS, permitting daily assessments of overall health and well-being of the mice, and providing a valuable repository for detailed behavioral analysis. We previously reported that, as compared to GC mice, RR1 FLT mice exhibited the same range of behaviors, including eating, drinking, exploration, self- and allo-grooming, and social interactions at similar or greater levels of occurrence. Overall activity was greater in FLT as compared to GC mice, with spontaneous ambulatory behavior, including organized 'circling' or 'race-tracking' behavior that emerged within the first few days of flight following a common developmental sequence, and comprised the primary dark cycle activity persisting throughout the remainder of the experiment. Participation by individual mice increased dramatically over the course of the flight. Here we present a detailed analysis of 'race-tracking' behavior in which we quantified: (1) Complete lap rotations by individual mice; (2) Numbers of collisions between circling mice; (3) Lap directionality; and (4) Recruitment of mice into a group

  11. Exposure to Family Violence and Internalizing and Externalizing Problems Among Spanish Adolescents.

    Science.gov (United States)

    Izaguirre, Ainhoa; Calvete, Esther

    2018-04-01

    Exposure to intimate partner violence (IPV) and child maltreatment may have devastating consequences on children's development. The aim of this research was to examine the predictive associations between exposure to violence at home (witnessing violence against the mother and/or direct victimization by the parents) and adolescent internalizing and externalizing problems. A total of 613 Spanish adolescents (13-18 years) took part in this study. Results indicate that psychological victimization by the parents predicted an increase in anxious/depressive symptoms, aggressive and rule-breaking behavior, and substance abuse at Time 2. In addition, rule-breaking behavior predicted an increase in adolescents' substance abuse at Time 2. Concerning gender, psychological victimization predicted an increase in anxiety/depression, aggressive behavior, rule-breaking behavior, and substance abuse in boys; whereas in girls, psychological victimization only predicted an increase in anxiety/depression.

  12. Predictors of Posttraumatic Stress Symptoms Among Adolescent and Young Adult Survivors of Childhood Cancer: Importance of Monitoring Survivors' Experiences of Family Functioning.

    Science.gov (United States)

    Kamibeppu, Kiyoko; Murayama, Shiho; Ozono, Shuichi; Sakamoto, Naoko; Iwai, Tsuyako; Asami, Keiko; Maeda, Naoko; Inada, Hiroko; Kakee, Naoko; Okamura, Jun; Horibe, Keizo; Ishida, Yasushi

    2015-11-01

    The purpose of this study was to identify factors associated with posttraumatic stress symptoms (PTSS) among Japanese long-term childhood cancer survivors (CCSs). Subjects comprised 185 adolescent and young adult (AYA) CCSs who completed anonymous self-report questionnaires. Attending physicians also completed an anonymous disease/treatment data sheet. Mean age of survivors was approximately 8 years at diagnosis and 23 years at participation. Multiple regression analysis showed that family functioning, satisfaction with social support, being female, and interactions between family functioning and gender and age at the time of diagnosis were associated with PTSS among survivors. This study revealed family functioning as the most predictive factor of PTSS among AYA CCSs in Japan. Even when the survivor may have unchangeable risk factors, family functioning can potentially moderate the effects on PTSS. Thus, it is crucial for health professionals to carefully monitor and attend to survivors' experiences of family functioning to mitigate PTSS. © The Author(s) 2015.

  13. A pilot study of self-esteem as a mediator between family factors and depressive symptoms in young adult university students.

    Science.gov (United States)

    Restifo, Kathleen; Akse, Joyce; Guzman, Natalie Valle; Benjamins, Caroline; Dick, Katharina

    2009-03-01

    The aim of this study was to examine whether self-esteem mediates the relationship between family factors and depressive symptoms in young adults. Participants completed self-report questionnaires about overall family environment, conflict with mother or father, parental rearing, self esteem, and depressive symptoms. Self-esteem was found to mediate the relationship between the combined family factors and depressive symptoms. When examined simultaneously, none of the individual family variables uniquely predicted depressive symptoms or self-esteem. However, separate analysis of each of the three family factors provided evidence for self-esteem mediating the relationship between parental conflict and depressive symptoms, and the relationship between parental care and depressive symptoms. Self-esteem may play a role in the mechanism underlying the link between parent-offspring relationship factors and depressive symptoms.

  14. [Use of contraception and family planning in adolescent and adult women in Mexico].

    Science.gov (United States)

    Allen-Leigh, Betania; Villalobos-Hernández, Aremis; Hernández-Serrato, María I; Suárez, Leticia; de la Vara, Elvia; de Castro, Filipa; Schiavon-Ermani, Raffaela

    2013-01-01

    To offer current evidence about age at sexual initiation and contraceptive use among adolescent and adult women of different age groups, places of residence, and marital status in Mexico. Data were analyzed from ENSANUT 2006 and 2012 surveys on knowledge and use of contraceptives. In 2012 31.2% of 15-19 year old adolescent women had undergone sexual debut. Condom use increased from 31.8% in 2006 to 47.8% in 2012. Women in rural areas reported lower levels of contraceptive use at last sexual intercourse; 47.9% of 30-34 year-old and 53.2% of 35-49 year-old women reported not using any contraception at last sexual intercourse. A high percentage of women did not adopt contraception after the most recent obstetric event: 52% (15-19 years), 44.2% (20-29 years), 42.5% (30-34 years) and 39% (≥35 years)]. Equitable policies to promote contraception, particularly after a post-obstetric event, are needed.

  15. How Family Support and Internet Self-Efficacy Influence the Effects of E-Learning among Higher Aged Adults--Analyses of Gender and Age Differences

    Science.gov (United States)

    Chu, Regina Ju-chun

    2010-01-01

    Gender and age differences in the effects of e-learning, including students' satisfaction and Internet self-efficacy, have been supported in prior research. What is less understood is how these differences are shaped, especially for higher aged adults. This article examines the utility of family support (tangible and emotional) and Internet…

  16. 'You don't show everyone your weakness': Older adults' views on using Family Group Conferencing to regain control and autonomy

    NARCIS (Netherlands)

    Metze, R.N.; Kwekkeboom, R.H.; Abma, T.A.

    2015-01-01

    Aim: Family Group Conferencing (FGC), a model in which a person and his or her social network make their own 'care' plan, is used in youth care and might also be useful in elderly care to support older persons living at home. In Amsterdam, the Netherlands, FGC was implemented for older adults but

  17. Contributions of maternal and paternal adiposity and smoking to adult offspring adiposity and cardiovascular risk: the Midspan Family Study.

    Science.gov (United States)

    Han, T S; Hart, C L; Haig, C; Logue, J; Upton, M N; Watt, G C M; Lean, M E J

    2015-11-02

    Obesity has some genetic basis but requires interaction with environmental factors for phenotypic expression. We examined contributions of gender-specific parental adiposity and smoking to adiposity and related cardiovascular risk in adult offspring. Cross-sectional general population survey. Scotland. 1456 of the 1477 first generation families in the Midspan Family Study: 2912 parents (aged 45-64 years surveyed between 1972 and 1976) who had 1025 sons and 1283 daughters, aged 30-59 years surveyed in 1996. Offspring body mass index (BMI), waist circumference (WC), cardiometabolic risk (lipids, blood pressure and glucose) and cardiovascular disease as outcome measures, and parental BMI and smoking as determinants. All analyses adjusted for age, socioeconomic status and family clustering and offspring birth weight. Regression coefficients for BMI associations between father-son (0.30) and mother-daughter (0.33) were greater than father-daughter (0.23) or mother-son (0.22). Regression coefficient for the non-genetic, shared-environment or assortative-mating relationship between BMIs of fathers and mothers was 0.19. Heritability estimates for BMI were greatest among women with mothers who had BMI either parents, offspring with two obese parents had adjusted OR of 10.25 (95% CI 6.56 to 13.93) for having WC ≥102 cm for men, ≥88 cm women, 2.46 (95% CI 1.33 to 4.57) for metabolic syndrome and 3.03 (95% CI 1.55 to 5.91) for angina and/or myocardial infarct (pparental adiposity nor smoking history determined adjusted offspring individual cardiometabolic risk factors, diabetes or stroke. Maternal, but not paternal, smoking had significant effects on WC in sons (OR=1.50; 95% CI 1.13 to 2.01) and daughters (OR=1.42; 95% CI 1.10 to 1.84) and metabolic syndrome OR=1.68; 95% CI 1.17 to 2.40) in sons. There are modest genetic/epigenetic influences on the environmental factors behind adverse adiposity. Maternal smoking appears a specific hazard on obesity and metabolic

  18. Current and Potential Support for Chronic Disease Management in the United States: The Perspective of Family and Friends of Chronically Ill Adults

    Science.gov (United States)

    Rosland, Ann-Marie; Heisler, Michele; Janevic, Mary; Connell, Cathleen; Langa, Kenneth M.; Kerr, Eve A.; Piette, John D.

    2013-01-01

    Objectives Family members and friends can be an important source of self-management support for older adults with chronic diseases. We characterized the U.S. population of potential and current “disease management supporters” for people with chronic illness who are ADL-independent, the help that supporters could provide, and barriers to increasing support. Methods Nationally-representative survey of U.S. adults (N=1,722). Results 44% of respondents (representing 100 million US adults) help a family member or friend with chronic disease management; another 9% (representing 21 million US adults) are willing to start. Most are willing to assist with key tasks such as medication use and communicating with providers, although they feel constrained by privacy concerns and a lack of patient health information. Discussion The majority of U.S. adults already help or would be willing to help one of their family members or friends with chronic illness care. Supporters' specific concerns could be addressed through innovative programs. PMID:23795624

  19. The impacts of community social capital on the life satisfaction of older adults in Hong Kong: the moderator role of intergenerational family capital.

    Science.gov (United States)

    Lu, Nan; Lum, Terry Y S; Lou, Vivian W Q

    2016-11-01

    This study examined the moderator role of intergenerational family capital on the relationship between community social capital and life satisfaction of older Chinese adults. The data were derived from a quota sampling of 372 older adults aged 60 and above, who were interviewed at four districts in Hong Kong in 2011. Multiple group analysis was employed to examine the proposed model. For the low family capital group, community social capital was found to be a significant predictor of life satisfaction, even when the well-known covariates were controlled. However, the association between community social capital and life satisfaction was statistically non-significant among the high family capital group. The findings highlighted the interplay between community social capital and intergenerational family capital, which supported community social capital replacement theory in understanding the mechanism linking social capital to life satisfaction in older age in a Chinese context. Community social capital can play a compensatory role in maintaining the mental health of older people. It is particularly important for older adults who lack family support and/or suffer from social isolation and loneliness in local communities.

  20. "Young people, adult worries": RCT of an internet-based self-support method "Feel the ViBe" for children, adolescents and young adults exposed to family violence, a study protocol

    NARCIS (Netherlands)

    Rosmalen-Nooijens, K.A.W.L. van; Prins, J.B.; Vergeer, M.; Wong, S.H.; Lagro-Janssen, A.L.M.

    2013-01-01

    BACKGROUND: Violence in families affects children. Exposure to violence is seen as child abuse. Figures show that about one third of children exposed to violence become victim or perpetrator in their adult life: known as intergenerational transmission. Violence also affects sexual and reproductive

  1. Young people, adult worries: Randomized controlled trial and feasibility study of the internet-based self-support method "Feel the ViBe" for adolescents and young adults exposed to family violence

    NARCIS (Netherlands)

    Rosmalen-Nooijens, K.A. van; Lo Fo Wong, S.H.; Prins, J.B.; Lagro-Janssen, T.

    2017-01-01

    BACKGROUND: Adolescents and young adults (AYAs) are of special interest in a group of children exposed to family violence (FV). Past-year prevalence of exposure to FV is known to be highest in AYAs and has severe consequences. Peer support is an effective approach to behavior change and the Internet

  2. Discrimination, internalized racism, and depression: A comparative study of African American and Afro-Caribbean adults in the US

    Science.gov (United States)

    Molina, Kristine M.; James, Drexler

    2016-01-01

    Emerging research suggests that both perceptions of discrimination and internalized racism (i.e., endorsement of negative stereotypes of one’s racial group) are associated with poor mental health. Yet, no studies to date have examined their effects on mental health with racial/ethnic minorities in the US in a single study. The present study examined: (a) the direct effects of everyday discrimination and internalized racism on risk of DSM-IV criteria of past-year major depressive disorder (MDD); (b) the interactive effects of everyday discrimination and internalized racism on risk of past-year MDD; and (c) the indirect effect of everyday discrimination on risk of past-year MDD via internalized racism. Further, we examined whether these associations differed by ethnic group membership. We utilized nationally representative data of Afro-Caribbean (N = 1,418) and African American (N = 3,570) adults from the National Survey of American Life. Results revealed that experiencing discrimination was associated with increased odds of past-year MDD among the total sample. Moreover, for Afro-Caribbeans, but not African Americans, internalized racism was associated with decreased odds of meeting criteria for past-year MDD. We did not find an interaction effect for everyday discrimination by internalized racism, nor an indirect effect of discrimination on risk of past-year MDD through internalized racism. Collectively, our findings suggest a need to investigate other potential mechanisms by which discrimination impacts mental health, and examine further the underlying factors of internalized racism as a potential self-protective strategy. Lastly, our findings point to the need for research that draws attention to the heterogeneity within the U.S. Black population. PMID:28405176

  3. Toxicity of Millettia ferruginea darasana (family: Fabaceae) against the larvae and adult ticks of Amblyomma variegatum Fabricius a three-host tick in cattle.

    Science.gov (United States)

    Choudhury, Manash Kumar; Shiferaw, Yoseph; Hussen, Ahmed

    2015-06-01

    The in vitro toxicity of Millettia ferruginea darasana (family: Fabaceae) was tested against the larvae adult male and female of a three-host tick, Amblyomma variegatum Fabricius (family: Ixodidae or hard tick), known as 'tropical bont tick' parasitic mainly to cattle found in Ethiopia and other equatorial Africa. The 20, 40, 60, 80 and 100 % concentrations of the seed oil extracted with petroleum ether were found to kill all (100 % mortality) larvae after 12, 9, 6, 3 and 1.5 h respectively. The results summarized in the Table 1 was found to be statistically significant at the probability level of p = 0.05. The 100 % concentration of the oil caused 100 % mortality of adult male, adult female and fully engorged female tick after 5, 7 and 12 h respectively. The root and root bark showed less toxicity. The leaves did not show any toxicity. [Table: see text].

  4. Impact of race and diagnostic label on older adults' emotions, illness beliefs, and willingness to help a family member with osteoarthritis.

    Science.gov (United States)

    Mingo, Chivon A; McIlvane, Jessica M; Haley, William E; Luong, My-Linh N

    2015-04-01

    To examine how race and the diagnostic label of Osteoarthritis (OA) affects older adults' emotions, illness beliefs, and willingness to help a family member. African American and White older adults were randomly assigned to read vignettes describing a sister suffering from chronic pain and disability, either with or without the OA label. Race × diagnostic label ANOVAs were conducted. Compared to Whites, African Americans were more optimistic that OA could improve with health care, and showed greater willingness to help their sister. The OA label had little impact on emotions, beliefs, or willingness to help. African Americans rated the sister as having more control of their problem than Whites without the OA label, but providing the diagnosis eliminated this difference. The diagnostic label of OA had little effect on these older adults, but racial differences indicate that cultural values regarding family caregiving are important in arthritis care. © The Author(s) 2013.

  5. How Is Health Related to Literacy, Numeracy, and Technological Problem-Solving Skills among U.S. Adults? Evidence from the Program for the International Assessment of Adult Competencies (PIAAC)

    Science.gov (United States)

    Prins, Esther; Monnat, Shannon; Clymer, Carol; Toso, Blaire Wilson

    2015-01-01

    This paper uses data from the Program for the International Assessment of Adult Competencies (PIAAC) to analyze the relationship between U.S. adults' self-reported health and proficiencies in literacy, numeracy, and technological problem solving. Ordinal logistic regression analyses showed that scores on all three scales were positively and…

  6. Validation of DSM-5 age-of-onset criterion of attention deficit/hyperactivity disorder (ADHD) in adults: Comparison of life quality, functional impairment, and family function.

    Science.gov (United States)

    Lin, Yu-Ju; Lo, Kuan-Wu; Yang, Li-Kuang; Gau, Susan Shur-Fen

    2015-12-01

    The newly published Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) elevates the threshold of the ADHD age-of-onset criterion from 7 to 12 years. This study evaluated the quality of life and functional impairment of adults with ADHD who had symptoms onset by or after 7 years and examined the mediation effect of family function and anxiety/depression symptoms between ADHD diagnosis and quality of life and functional impairment. We assessed 189 adults with ADHD and 153 non-ADHD controls by psychiatric interview and self-administered reports on the Adult ADHD Quality of Life Scale, Weiss Functional Impairment Rating Scale, Family APGAR, and Adult Self Report Inventory-4. The ADHD group was divided into early-onset ADHD (onset ADHD (onset between 7 and 12 years, n=42). The mediation analysis was conducted to verify the mediating factors from ADHD to functional impairment and quality of life. The late-onset ADHD had more severe functional impairment at work and poorer family support than early-onset ADHD while they had comparable impairment at other domains. Less perceived family support and current anxiety/depressive symptoms partially mediated the link between ADHD diagnosis and quality of life/functional impairment both in early- and late-onset ADHD. Our data support decreased quality of life and increased functional impairment in adult ADHD, regardless of age of onset, and these adverse outcomes may be mediated by family support and anxiety/depression at adulthood. Our findings also imply that the new DSM-5 ADHD criteria do not over-include individuals without impairment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. International consensus on preliminary definitions of improvement in adult and juvenile myositis.

    Science.gov (United States)

    Rider, Lisa G; Giannini, Edward H; Brunner, Hermine I; Ruperto, Nicola; James-Newton, Laura; Reed, Ann M; Lachenbruch, Peter A; Miller, Frederick W

    2004-07-01

    To use a core set of outcome measures to develop preliminary definitions of improvement for adult and juvenile myositis as composite end points for therapeutic trials. Twenty-nine experts in the assessment of myositis achieved consensus on 102 adult and 102 juvenile paper patient profiles as clinically improved or not improved. Two hundred twenty-seven candidate definitions of improvement were developed using the experts' consensus ratings as a gold standard and their judgment of clinically meaningful change in the core set of measures. Seventeen additional candidate definitions of improvement were developed from classification and regression tree analysis, a data-mining decision tree tool analysis. Six candidate definitions specifying percentage change or raw change in the core set of measures were developed using logistic regression analysis. Adult and pediatric working groups ranked the 13 top-performing candidate definitions for face validity, clinical sensibility, and ease of use, in which the sensitivity and specificity were >/=75% in adult, pediatric, and combined data sets. Nominal group technique was used to facilitate consensus formation. The definition of improvement (common to the adult and pediatric working groups) that ranked highest was 3 of any 6 of the core set measures improved by >/=20%, with no more than 2 worse by >/=25% (which could not include manual muscle testing to assess strength). Five and 4 additional preliminary definitions of improvement for adult and juvenile myositis, respectively, were also developed, with several definitions common to both groups. Participants also agreed to prospectively test 6 logistic regression definitions of improvement in clinical trials. Consensus preliminary definitions of improvement were developed for adult and juvenile myositis, and these incorporate clinically meaningful change in all myositis core set measures in a composite end point. These definitions require prospective validation, but they are now

  8. SU119. Internalized Stigma in Adults With Early-Phase vs Prolonged Psychosis

    Science.gov (United States)

    Firmin, Ruth; Vohs, Jenifer; Luther, Lauren; Yanos, Philip; Leonhardt, Bethany; Lysaker, Paul

    2017-01-01

    Abstract Background: While internalized stigma is associated with negative outcomes among those with prolonged psychosis, surprisingly little work has focused on when in the course of one’s illness stigma is internalized and the impact of internalization on symptoms or quality of life over the course of the illness. Therefore, this study investigated whether (1) internalized stigma is greater among those later in the course of psychosis and (2) whether internalized stigma has a stronger negative relationship with quality of life or symptoms among those with prolonged compared to early-phase psychosis. Methods: Individuals with early-phase (n = 40) and prolonged psychosis (n = 71) who were receiving outpatient services at an early-intervention clinic and a VA medical center, respectively, completed self-report measures of internalized stigma and interview-rated measures of symptoms and quality of life. Results: Controlling for education, race, and sex differences, internalized stigma was significantly greater among those with prolonged compared to early-phase psychosis. Internalized stigma was negatively related to quality of life and positively related to symptoms in both groups. Furthermore, the magnitude of the relationship between cognitive symptoms and internalized stigma was significantly greater among those with early-phase psychosis. Stereotype endorsement, discrimination experiences, and social withdrawal also deferentially related to symptoms and quality of life across the 2 samples. Conclusion: Findings suggest that internalized stigma is an important variable to incorporate into models of early psychosis. Further, internalized stigma may be a possible treatment target among those in their early phase of psychosis.

  9. Physical health and wellbeing of emerging and young adults with mental illness: an integrative review of international literature.

    Science.gov (United States)

    McCloughen, Andrea; Foster, Kim; Huws-Thomas, Michelle; Delgado, Cynthia

    2012-06-01

    Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental-physical comorbidities in middle to older-aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16-24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental-physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid-late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health-care behaviours. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

  10. Psychological treatments for adults and children with epilepsy: Evidence-based recommendations by the International League Against Epilepsy Psychology Task Force.

    Science.gov (United States)

    Michaelis, Rosa; Tang, Venus; Goldstein, Laura H; Reuber, Markus; LaFrance, William Curt; Lundgren, Tobias; Modi, Avani C; Wagner, Janelle L

    2018-06-19

    Given the significant impact that psychosocial factors and epilepsy treatments can have on the health-related quality of life (HRQOL) of individuals with epilepsy and their families, there is great clinical interest in the role of psychological evaluation and treatments to improve HRQOL and comorbidities. Therefore, the International League Against Epilepsy (ILAE) charged the Psychology Task Force with the development of recommendations for clinical care based on evaluation of the evidence from their recent Cochrane review of psychological treatments in individuals with epilepsy. The literature search for a recent Cochrane review of randomized controlled trials investigating psychological treatments for individuals with epilepsy constitutes the key source of evidence for this article. To provide practical guidance to service providers, we provide ratings on study research designs based on (1) the American Academy of Neurology's Level of Evidence system and (2) the Grading of Recommendations, Assessment, Development, and Evaluation system. This paper is the culmination of an international collaboration process involving pediatric and adult psychologists, neurologists, psychiatrists, and neuropsychiatrists. The process and conclusions were reviewed and approved by the ILAE Executive Committee. The strongest evidence for psychological interventions was identified for the most common mental health problems, including depression, neurocognitive disturbances, and medication adherence. Psychological interventions targeting the enhancement of HRQOL and adherence and a decrease in comorbidity symptoms (anxiety, depression) should be incorporated into comprehensive epilepsy care. There is a range of psychological strategies (ie, cognitive behavioral therapy and mindfulness-based therapies) that show promise for improving the lives of persons with epilepsy, and clinical recommendations are provided to assist epilepsy health care providers in treating the comorbidities and

  11. Parental and offspring contribution of genetic markers of adult blood pressure in early life: The FAMILY study.

    Directory of Open Access Journals (Sweden)

    Sébastien Robiou-du-Pont

    Full Text Available Previous genome wide association studies (GWAS identified associations of multiple common variants with diastolic and systolic blood pressure traits in adults. However, the contribution of these loci to variations of blood pressure in early life is unclear. We assessed the child and parental contributions of 33 GWAS single-nucleotide polymorphisms (SNPs for blood pressure in 1,525 participants (515 children, 406 mothers and 237 fathers of the Family Atherosclerosis Monitoring In early life (FAMILY study followed-up for 5 years. Two genotype scores for systolic (29 SNPs and diastolic (24 SNPs blood pressure were built. Linear mixed-effect regressions showed significant association between rs1378942 in CSK and systolic blood pressure (β = 0.98±0.46, P = 3.4×10-2. The child genotype scores for diastolic and systolic blood pressure were not associated in children. Nominally significant parental genetic effects were found between the SNPs rs11191548 (CYP17A1 (paternal, β = 2.78±1.49, P = 6.1×10-2 for SBP and β = 3.60±1.24, P = 3.7×10-3 for DBP, rs17367504 (MTHFR (paternal, β = 2.42±0.93, P = 9.3×10-3 for SBP and β = 1.89±0.80, P = 1.8×10-2 for DBP and maternal, β = -1.32±0.60, P = 2.9×10-2 and β = -1.97±0.77, P = 1.0×10-2, for SBP and DBP respectively and child blood pressure. Our study supports the view that adult GWAS loci have a limited impact on blood pressure during the five first years of life. The parental genetic effects observed on blood pressure in children may suggest epigenetic mechanisms in the transmission of the risk of hypertension. Further replication is needed to confirm our results.

  12. Suicidal ideation among young French adults: association with occupation, family, sexual activity, personal background and drug use.

    Science.gov (United States)

    Legleye, S; Beck, F; Peretti-Watel, P; Chau, N; Firdion, J M

    2010-06-01

    To assess associations among young adults between suicidal ideation in the previous year and adverse childhood events, occupation, education, tobacco use, alcohol abuse, cannabis use in the previous month, illicit drug use, sexual orientation and activity, depression, physical violence in the previous year, and lifetime forced sexual intercourse. A subsample of 4075 French adults aged 18-30 years was drawn from a random national telephone survey in 2005. Major depressive episode and alcohol abuse were assessed using CIDI-SF and AUDIT-C (score above 4). Data were analysed with logistic regressions. Suicidal ideation affected 5.7% of men and 4.9% of women. Among men depression had the highest adjusted odds ratio (ORa=8.06, 5.07-12.79), followed by homosexual intercourse (3.37, 1.62-7.04), absence of sexual activity (2.83, 1.80-4.44); ORa between 1.6 and 2.0 were observed for living alone, daily tobacco smoking, being unemployed, serious health event concerning the father, age 26-30 and bad relationships between parents. Among women, depression had the highest ORa (7.60, 4.70-12.29), followed by lifetime experience of forced sexual intercourse (5.37, 2.89-9.96), having consumed illicit drugs other than cannabis (4.01, 1.48-10.89); ORa between 1.7 and 2.5 were observed for living alone, being unemployed, bad relationship between parents and age 26-30. Cross-sectional survey, sexual orientation inferred from sexual activity. Suicide prevention should integrate the fact that besides depression, unemployment, family history, age, and sexual activity and orientation are specific risk factors among men, whereas illicit drug use, violence and forced sexual intercourse are more important among women. Copyright 2009 Elsevier B.V. All rights reserved.

  13. Surface electromyography activity of the rectus abdominis, internal oblique, and external oblique muscles during forced expiration in healthy adults.

    Science.gov (United States)

    Ito, Kenichi; Nonaka, Koji; Ogaya, Shinya; Ogi, Atsushi; Matsunaka, Chiaki; Horie, Jun

    2016-06-01

    We aimed to characterize rectus abdominis, internal oblique, and external oblique muscle activity in healthy adults under expiratory resistance using surface electromyography. We randomly assigned 42 healthy adult subjects to 3 groups: 30%, 20%, and 10% maximal expiratory intraoral pressure (PEmax). After measuring 100% PEmax and muscle activity during 100% PEmax, the activity and maximum voluntary contraction of each muscle during the assigned experimental condition were measured. At 100% PEmax, the external oblique (pinternal oblique (pexternal oblique (pinternal oblique (pexternal oblique: pinternal oblique: p<0.01). The abdominal oblique muscles are the most active during forced expiration. Moreover, 30% PEmax is the minimum intensity required to achieve significant, albeit very slight, muscle activity during expiratory resistance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Daily Stressors and Adult Day Service Use by Family Caregivers: Effects on Depressive Symptoms, Positive Mood and DHEA-S

    Science.gov (United States)

    Zarit, Steven H.; Whetzel, Courtney A.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Rovine, Michael J.; Klein, Laura Cousino

    2014-01-01

    Objectives This study examines effects of daily use of adult day services (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. Design We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and non-intervention days to evaluate within- and between-person effects of the intervention. Setting Caregivers were interviewed daily by telephone at home. Participants 151 family caregivers of IWD who were using ADS. Measurements Saliva samples were collected from caregivers 5 times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. Results DHEA-S levels were significantly higher on days following ADS use. Daily DHEA-S levels covaried significantly with daily positive mood, but not depressive symptoms. Conclusions These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiological damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiological demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors. PMID:24566240

  15. Parent-child relationship quality and family transmission of parent posttraumatic stress disorder symptoms and child externalizing and internalizing symptoms following fathers' exposure to combat trauma.

    Science.gov (United States)

    Snyder, James; Gewirtz, Abigail; Schrepferman, Lynn; Gird, Suzanne R; Quattlebaum, Jamie; Pauldine, Michael R; Elish, Katie; Zamir, Osnat; Hayes, Charles

    2016-11-01

    Transactional cascades among child internalizing and externalizing symptoms, and fathers' and mothers' posttraumatic stress disorder (PTSD) symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents' positive engagement and coercive interaction with their child, and family members' emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and nondeployed mothers and their 4- to 13-year-old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child's symptoms. Parents' observed behavior during interaction with their children was coded using a multimethod approach at each assessment point. Reciprocal cascades among fathers' and mothers' PTSD symptoms, and child internalizing and externalizing symptoms, were observed. Fathers' and mothers' positive engagement during parent-child interaction linked their PTSD symptoms and their child's internalizing symptoms. Fathers' and mothers' coercive behavior toward their child linked their PTSD symptoms and their child's externalizing symptoms. Each family member's capacity for emotion regulation was associated with his or her adjustment problems at baseline. Implications for intervention, and for research using longitudinal models and a family-systems perspective of co-occurrence and cascades of symptoms across family members are described.

  16. Parent-Child Relationship Quality and Family Transmission of Parent Posttraumatic Stress Disorder Symptoms and Child Externalizing and Internalizing Symptoms Following Fathers’ Combat-Trauma Exposure

    Science.gov (United States)

    Snyder, James; Gewirtz, Abigail; Schrepferman, Lynn; Gird, Suzanne R.; Quattlebaum, Jamie; Pauldine, Michael R.; Elish, Katie; Zamir, Osnat; Hayes, Charles

    2016-01-01

    Transactional cascades among child internalizing and externalizing symptoms, and fathers’ and mothers’ post-traumatic stress disorder symptoms were examined in a sample of families with a male parent who had been deployed to recent military conflicts in the Middle East. The role of parents’ positive engagement and coercive interaction with their child, and family members’ emotion regulation were tested as processes linking cascades of parent and child symptoms. A subsample of 183 families with deployed fathers and non-deployed mothers and their 4 to 13 year old children who participated in a randomized control trial intervention (After Deployment: Adaptive Parenting Tools, or ADAPT) were assessed at baseline prior to intervention, and at 12 and 24 months after baseline, using parent reports of their own and their child’s symptoms. Parents’ observed behavior during interaction with their children was coded using a multi-method approach at each assessment point. Reciprocal cascades among fathers’ and mothers’ PTSD symptoms, and child internalizing and externalizing symptoms were observed. Fathers’ and mothers’ positive engagement during parent-child interaction linked their PTSD symptoms and their child’s internalizing symptoms. Fathers’ and mothers’ coercive behavior toward their child linked their PTSD symptoms and their child’s externalizing symptoms. Each family members’ capacity for emotion regulation was associated with their adjustment problems at baseline. Implications for intervention, and for research using longitudinal models and a family-systems perspective of co-occurrence and cascades of symptoms across family members are described. PMID:27739388

  17. Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International.

    Science.gov (United States)

    Munroe, Erik; Hayes, Brendan; Taft, Julia

    2015-06-17

    To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. We analyzed MSI's social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008-2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011-2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI "Impact 2" model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44.0), with 46.1% (95% CI = 40.9, 51.2) of

  18. Private-Sector Social Franchising to Accelerate Family Planning Access, Choice, and Quality: Results From Marie Stopes International

    Science.gov (United States)

    Munroe, Erik; Hayes, Brendan; Taft, Julia

    2015-01-01

    Background: To achieve the global Family Planning 2020 (FP2020) goal of reaching 120 million more women with voluntary family planning services, rapid scale-up of services is needed. Clinical social franchising, a service delivery approach used by Marie Stopes International (MSI) in which small, independent health care businesses are organized into quality-assured networks, provides an opportunity to engage the private sector in improving access to family planning and other health services. Methods: We analyzed MSI’s social franchising program against the 4 intended outputs of access, efficiency, quality, and equity. The analysis used routine service data from social franchising programs in 17 African and Asian countries (2008–2014) to estimate number of clients reached, couple-years of protection (CYPs) provided, and efficiency of services; clinical quality audits of 636 social franchisees from a subset of the 17 countries (2011–2014); and exit interviews with 4,844 clients in 14 countries (2013) to examine client satisfaction, demographics (age and poverty), and prior contraceptive use. The MSI “Impact 2” model was used to estimate population-level outcomes by converting service data into estimated health outcomes. Results: Between 2008 and 2014, an estimated 3,753,065 women cumulatively received voluntary family planning services via 17 national social franchise programs, with a sizable 68% choosing long-acting reversible contraceptives (LARCs). While the number of social franchisee outlets increased over time, efficiency also significantly improved over time, with each outlet delivering, on average, 178 CYPs in 2008 compared with 941 CYPs in 2014 (P = .02). Clinical quality audit scores also significantly improved; 39.8% of social franchisee outlets scored over 80% in 2011 compared with 84.1% in 2014. In 2013, 40.7% of the clients reported they had not been using a modern method during the 3 months prior to their visit (95% CI = 37.4, 44

  19. Development of a new mathematical model representing the head region of the adult human for use in internal dose calculations

    International Nuclear Information System (INIS)

    Facioli, L.M.

    1984-01-01

    It is presented a new mathematical model to determine the spatial distribution of the scattered radiation, or specific absorbed fractions, in the head of the adult man. The ALGAM computer code which calculates the internal dose from gamma-ray sources in a man phanton, was modified to include the model proposed. The new program was processed for two source organs: thyroid and brain for 12 incident photon energies ranging from 0.010 to 4.0 MeV. (M.C.K.) [pt

  20. An International Look at the Single-Parent: Family Structure Matters More for U.S. Students

    Science.gov (United States)

    Woessmann, Ludger

    2015-01-01

    When Daniel Patrick Moynihan raised the issue of family structure half a century ago, his concern was the increase in black families headed by women. Since then, the share of children raised in single-parent families in the United States has grown across racial and ethnic groups and with it evidence regarding the impact of family structure on…