Stability and change in family psychosocial risk over 6 months in pediatric cancer and its association with medical and psychosocial healthcare utilization

Purpose: Family psychosocial risk in pediatric oncology can be assessed using the Psychosocial Assessment Tool (PAT), a brief parent report screener based on the Pediatric Psychosocial Preventative Health Model (PPPHM; universal, targeted, and clinical). However, little is known about risk over the course of treatment and its association with medical and psychosocial healthcare utilization. Methods: Primary caregivers of children with cancer participated in this prospective multisite investigation, completing the PAT at diagnosis (T1; n = 396) and 6 months later (T2; n = 304). Healthcare utilization data were extracted from electronic health records. Results: The distribution of PPPHM risk levels at T1 and T2 was highly consistent for the samples. Two‐thirds of families remained at the same level of risk, 18% decreased and 16% increased risk level. Risk was not related to sociodemographic or treatment variables. The PAT risk score correlated with psychosocial contacts over the 6‐month period. Conclusions: Although the majority of families reported universal (low) risk on the PAT and were stable in their risk level over 6 months, reassessing risk is helpful in identifying those families who report higher level of risk during treatment than at diagnosis. PAT scores were related to psychosocial services that are provided to most but not all families and could be tailored more specifically to match risk and delivery of evidence‐based care.     

Stitching the fabric back together: child fostering attitudes in the transition to a chronic HIV epidemic

There are an estimated 56 million orphans and vulnerable children across sub-Saharan Africa. Communities typically care for orphan children through informal caring arrangements – either within or outside of kinship networks. Within Kenya, an estimated 250,000 children live on the streets. There is less research related to fostering attitudes of this special population than orphans and vulnerable children generally. Important research over the past decade has illuminated multiple ways in which children are made more vulnerable because of HIV, including parental death and street-migration from HIV-affected households. As HIV transitions from a terminal illness to a chronic, manageable one, research is also required to establish how parents living with HIV can be an asset to children. In this study, we assess whether mothers living with HIV were very willing to foster biologically-related children, and street-involved children, how these fostering attitudes differed from mothers not living with HIV, and whether differences in fostering attitudes by reported HIV status were mediated by social support, family functioning and general self-rated health. Approximately 40% of mothers living with HIV were very willing to provide long-term foster care to biologically-related or street-involved children. This was less than the percentage of mothers not living with HIV, who were very willing to foster biologically-related children (61%) or street-involved children (58%). Significant portions of these differences were explained by social support, family functioning and general self-rated health. Multi-sectoral approaches are suggested by these findings in order to improve the child-fostering capacity of mothers living with HIV. Improving social support, family functioning and general self-rated health among HIV-infected mothers may not only provide protective benefits for the mothers and their children, but also expand the community’s capacity to care for orphan and vulnerable children.     

The Influence of Academic Support on Latino Adolescents’ Academic Motivation

Abstract: The current study examined the extent to which mothers, fathers, teachers, and teenage friends influenced Latino adolescents’ academic motivation. Using path analysis, separate models were tested for 154 Latino boys and 156 Latina girls. Findings indicated that mothers’ and teachers’ academic support were positively related to adolescent girls’ academic motivation, and fathers’ and teachers’ academic support were positively related to adolescent boys’ academic motivation. The salience of teachers’ support, possible reasons for gender differences, and implications for future research are discussed.     

Levels of Psychological Distress Experienced by Family Carers of Children and Adolescents with Intellectual Disabilities in an Urban Conurbation

Background The aim of the present study was to identify factors associated with the level of psychological distress reported by family carers of children with intellectual disability living in a large urban conurbation. Method Information was collected by postal questionnaire (or interview for family carers who did not have English as their first language) from the family carers of 408 children with intellectual disability (31% of all children within the area administratively identified as having an intellectual disability). Results Results indicated that 47% of primary carers scored above the threshold for psychological distress on the GHQ and that scoring above the threshold was strongly related to the emotional and behavioural needs of the index child and South‐Asian ethnicity and moderately associated with the severity of the child's delay in communication. Conclusions The rates of psychological distress (47% overall, 70% among South‐Asian carers) were markedly higher than that found in previous studies of carers supporting a child with intellectual disabilities. It is suggested that these elevated rates of psychological distress may be mediated by socio‐economic deprivation.     

New alleles at microsatellite loci in CEPH families mainly arise from somatic mutations in the lymphoblastoid cell lines

In the analysis of 40 CEPH families, under the EUROGEM project, with a total of 29 microsatellites (26 CA-repeats, a TCTA-repeat within the vWFII-3 gene, a TTA-repeat within the PLA-2 gene, and an AAAT-repeat intragenic to the NF1 gene) from human chromosomes 12, 17, and 21, we have detected 21 cases of abnormal segregation of alleles in 16 pedigrees for a total of 14 markers (48%). In 11 cases, the abnormal transmissions were of somatic origin, 10 of which (91%) occurred in the lymphoblastoid cell lines. In 9 other cases, it was not possible to determine if the origin of the new alleles was somatic or germline, and in one case hemizygosity in several family members was observed, so its origin was germline. The 20 new mutations detected in the 22,852 meioses analysed represent a mutation frequency of 8.7 × 10^?4 per locus per allele. The germline mutation rate could be as high as 3.9 × 10^?4 per locus per gamete (from 0 to 3.9 × 10^?4), but the rate of somatic mutations detected in the study was much higher (4.8 × 10^?4 to 8.7 × 10^?4 per locus per allele). Individual mutation rates ranged from 0 to 3.8 × 10^?3. Among the markers analysed, all three that were tri- or tetranucleotide repeats showed one or two new alleles, compared to only 10 of the 26 (38%) CA-repeats showing mutations. Three CEPH families (102, 45 and 1333) each had several mutational events, and one individual (10210) had somatic mutations for two microsatellites from different chromosomes. The mutation rate at microsatellite loci within families, using DNA directly obtained from cells from the individual, is less than 1 × 10^?4 (true germline mutation rate), which should not affect the use of these markers in diagnosis and linkage. However, these results and previous data suggest that for DNA obtained from cell lines, mutations are much more frequent (1 × 10^?2?1 × 10^?3). © 1994 Wiley-Liss, Inc.     

避孕措施与细菌性阴道病关系的研究

目的：探讨避孕措施与细菌性阴道病（BV）的关系，为预防BV、指导选择避孕措施提供依据。方法：对某医院妇科门诊接受计划生育服务的育龄妇女非选择性地进行BV筛检。以筛检出的267例BV患者为病例组，其余478例未患BV且无BV史的妇女为对照组进行病例对照研究。结果：与未采用避孕措施者比较，单因素logistic回归分析显示：BV与IUD有正关联，而与避孕套、口服避孕药（OC）无关联。经婚姻状况、性卫生、性行为习惯调整后，BV与IUD的关联仍有统计学意义（OR=2．364，95％C1：1．216～3．620），但与OC及避孕套使用无关。同IUD使用者比较，BV与避孕套使用呈负关联，调整后的OR=0．299（95％C1：0．158～0．566）；BV与OC使用间无关联。结论：使用IUD与未采用避孕措施者比较可能增加BV发生的危险，而避孕套使用者发生BV危险低于IUD使用者。无论从避孕还是预防BV角度，避孕套均是一种较好的选择。     

Relationships between demographic variables and family dynamics of childbearing families

Hakulinen T, Paunonen M, Laippala P. International Journal of Nursing Practice 1997; 3: 247–254
Relationships between demographic variables and family dynamics of childbearing families
In this study relationships between demographic variables and family dynamics of childbearing families in Finland were studied. The sample was 160 urban families expecting their first or second child in the third trimester of pregnancy. One-hundred and eighteen families participated in the study. The Family Dynamics Questionnaire (FDQ) and the Family Dynamics Measure (FDM) were used in this study. Most expectant parents reported their family was well-functioning. Mothers of higher socioeconomic status found more flexibility in their families than mothers of lower socioeconomic status. Fathers in families expecting their first baby reported more mutuality, role reciprocity and more stability than second-time fathers. The findings contribute cues for public health nurses and midwives regarding parity, socioeconomic status and family dynamics to provide more specific family guidance during the transition to parenthood. Realistic information on the changes in family dynamics after childbirth should be given to pregnant parents.     

贫困山区育龄妇女健康状况调查分析

育龄妇女的健康状况。可以反映一个地区的社会经济发展水平，也可反映当地医疗保健服务的水平以及群众利用服务的能力。通过对贫困山区岳西县555名育龄妇女的健康状况及影响因素进行分析，发现常见病、多发病仍威胁贫困山区育龄妇女的健康，同时家庭经济状况直接影响农村育龄妇女对卫生服务的利用。     

The impact of combat trauma across the family life cycle: Clinical considerations

Clinical experience and research with veterans of the Second World War and subsequent military conflicts have demonstrated the longstanding nature of combat-related post-traumatic stress disorder and the reverberating effects upon the families of traumatized individuals. The consequences of combat trauma during various stages of family life are discussed. Specifically, the impact upon (a) courtship and mate selection, (b) marriage, (c) childbirth and childrearing, (d) marriage in mid-life, (e) children leaving home, and (f) retirement in late life are reviewed. Finally, clinical considerations for the practice of family psychotherapy in this area are presented.Portions of this paper were presented at the First European Congress of Psychology, Amsterdam, The Netherlands, July 6, 1989. Support for the preparation of this paper was provided by the Medical Research Service of the Department of Veterans Affairs. The opinions expressed in this article are those of the authors and do not necessarily represent those of the Department of Veterans Affairs. The authors extend their gratitude to Drs. Barbara McClure and Harvey A. Taub for their editorial assistance on an earlier version of this article.     

北京和重庆市育龄期妇女风疹抗体水平调查

目的了解北京和重庆市育龄期妇女风疹抗体水平,为控制先天性风疹综合征(CRS)提供科学依据。方法2006年6~8月随机抽取北京和重庆市各1个区作为调查点,对20~39岁育龄期妇女623人(北京市311人,重庆市312人)进行血清流行病学调查。结果北京和重庆市育龄期妇女风疹抗体阳性率分别为85.21%和78.53%,自然感染获得抗体阳性率分别为85.08%和77.89%;风疹抗体分布与年龄、地区有关,随着年龄的增长抗体阳性率和几何平均浓度有下降的趋势。结论制定科学的风疹疫苗使用策略和免疫程序,提高育龄期妇女的免疫力,是减少CRS发病的有效手段。