In the planning of community-based genetics education campaigns, we cannot assume the existence of a single-minded, passively receptive public, simply waiting to be "educated." Rather, we must consider the impact of preexisting circumstances, notably the differential life-status conditions, the special concerns, and individual motivations of the persons to be educated on their search for information that matters to them. Messages promulgated by mass media educational campaigns on issues in genetics typically do not fall on a homogeneous mass of equally responsive ears and eyes, even if the target population superficially appears to be homogeneous and preselected. Especially institutional sources, (e.g., schools and general education) for males, and social relations (e.g., informal contact among friends) for females are crucial strategic variables affecting transmission and reception of knowledge of Tay-Sachs disease.

Communication↗

PubMed1973

Changes in structure and mechanical properties of the rat aorta induced by a hypertensive period during development.

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Animals↗

PubMed1970

What wives say about nursing homes.

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Attitude to Health↗

PubMedDate not supplied

Uncomplicated and comorbid obsessive-compulsive disorder in an epidemiologic sample.

This study investigated lifetime prevalence rates, demographic characteristics, childhood conduct disorder and adult antisocial features, suicide attempts, and cognitive impairment in individuals with obsessive-compulsive disorder (OCD) uncomplicated by or comorbid with any other psychiatric disorder. The data are from the NIMH Epidemiologic Catchment Area (ECA) study, and the current analyses compared subjects with uncomplicated OCD (no history of any other lifetime psychiatric disorder), comorbid OCD (with any other lifetime disorder), other lifetime psychiatric disorders, and no lifetime psychiatric disorders across these variables. OCD in its uncomplicated and comorbid form had significantly higher rates of childhood conduct symptoms, adult antisocial personality disorder problems, and of suicide attempts than did no or other disorders. Comorbid OCD subjects had higher rates of mild cognitive impairment on the Mini-Mental Status Exam than did subjects with other disorders. These findings suggest that a subgroup of OCD patients may have impulsive features, including childhood conduct disorder symptoms and an increased rate of suicide attempts; wider clinical attention to these outcomes is needed.

Adolescent↗

PubMedDate not supplied

Childhood obsessive-compulsive disorder in the NIMH MECA study: parent versus child identification of cases. Methods for the Epidemiology of Child and Adolescent Mental Disorders.

Abstract-Because as many as 50% of obsessive-compulsive disorder (OCD) cases have had onset by age 15, interest in its detection in childhood is strong. Clinical experience indicates that children often try to keep their OCD secret and that parental report may give marked underestimates. The authors examined the prevalence of childhood OCD in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, a four-site community survey which allowed comparison of both parent and child report of the child's OCD and related symptoms and disorders. OCD cases, based on structured interviews (DISC-2.3 with DSM-III-R criteria) with 1,285 caretaker-child pairs, were identified separately for parent and child (aged 9 through 17) informants from the MECA database. Cases were then examined for demographic characteristics, for obsessive-compulsive symptoms and other diagnoses reported in cases "missed" by one reporter, and for comorbid disorders. Of a total of 35 (2.7%) identified cases, four (0.3%) were identified by the parent and 32 (2.5%) were identified by the child, with only one overlapping case. In general, when OCD cases were "missed" by one reporter, that reporter did not substitute another disorder. These findings support clinical data that children with OCD often hide their illness and underscore the importance of child interviews for its detection.

Adolescent↗

PubMedDate not supplied

Effect of age and sex on residual stress in the aorta.

When ring segments of artery free of external loads are cut longitudinally, they spring open. This property which has been termed residual strain, is a manifestation of an underlying residual stress and may be quantified by measuring the degree to which the cut ring springs open. Residual stress serves to redistribute the forces in the media and to minimize the stress gradient between its inner and outer margins. Its magnitude and distribution are closely related to vascular growth and development. We have measured the degree of opening (in terms of an opening angle, see below for its definition) in 168 rings removed from six positions along aortae obtained at autopsy from 30 subjects aged between 3 months and 87 years. At all ages, there was an overall increase in opening angle along the aorta away from the heart. At all positions, the opening angle increased with age and was higher in vessels with visible atheroma. At all ages, the opening angle was significantly greater in males than in females. This difference persisted when allowance was made for the greater incidence of atheroma in males. We have found a similar age-related increase in rats, although there was no difference between males and females. These observations are consistent with a recently proposed 'stress-growth' law in which remodelling of the arterial wall is driven by the non-uniform distribution of stress across it and may be associated with known sex-related differences in the aetiology of cardiovascular disease.

Adolescent↗

PubMedDate not supplied

What happens to depressed men? Application of the Stirling County criteria.

In a recent issue of the Harvard Review of Psychiatry, results from the Stirling County Study showed that the prevalence and incidence rates of depression were similar in men and women when "gender-fair" criteria were used and help-seeking was not required. We attempted to replicate these findings by applying the criteria for depression from the Stirling County Study to two national and six international epidemiologic surveys conducted in the 1980s and 1990s. Depression was defined as dysphoric mood and disturbances of sleep, appetite, and energy, with at least a mild degree of impairment. The rates of depression were computed using this algorithm with data from the US Epidemiologic Catchment Area Study, conducted in the 1980s, the US National Comorbidity Survey, conducted in the 1990s, and independent community surveys from Canada, Puerto Rico, France, Taiwan, Korea, and New Zealand. For the US studies, these rates were recalculated after persons seeking treatment were removed from the analyses, where such data were available. Using Stirling County Study criteria, the lifetime prevalence rate of depression remains approximately twice as high in women as in men cross-nationally, except in Puerto Rico. Excluding help-seeking as a criterion and controlling for birth cohort do not change the findings. The Stirling County findings on absence of a sex difference in rates of depression using "gender-fair" criteria may be due to methodological variance in the collection of data, sample size, or the social and/or genetic uniqueness of the Atlantic Canadian community.

Adolescent↗

PubMedDate not supplied

Cross-national epidemiology of major depression and bipolar disorder.

OBJECTIVE: To estimate the rates and patterns of major depression and bipolar disorder based on cross-national epidemiologic surveys. DESIGN AND SETTING: Population-based epidemiologic studies using similar methods from 10 countries: the United States, Canada, Puerto Rico, France, West Germany, Italy, Lebanon, Taiwan, Korea, and New Zealand. PARTICIPANTS: Approximately 38000 community subjects. OUTCOME MEASURES: Rates, demographics, and age at onset of major depression and bipolar disorder. Symptom profiles, comorbidity, and marital status with major depression. RESULTS: The lifetime rates for major depression vary widely across countries, ranging from 1.5 cases per 100 adults in the sample in Taiwan to 19.0 cases per 100 adults in Beirut. The annual rates ranged from 0.8 cases per 100 adults in Taiwan to 5.8 cases per 100 adults in New Zealand. The mean age at onset shows less variation (range, 24.8-34.8 years). In every country, the rates of major depression were higher for women than men. By contrast, the lifetime rates of bipolar disorder are more consistent across countries (0.3/100 in Taiwan to 1.5/100 in New Zealand); the sex ratios are nearly equal; and the age at first onset is earlier (average, 6 years) than the onset of major depression. Insomnia and loss of energy occurred in most persons with major depression at each site. Persons with major depression were also at increased risk for comorbidity with substance abuse and anxiety disorders at all sites. Persons who were separated or divorced had significantly higher rates of major depression than married persons in most of the countries, and the risk was somewhat greater for divorced or separated men than women in most countries. CONCLUSIONS: There are striking similarities across countries in patterns of major depression and of bipolar disorder. The differences in rates for major depression across countries suggest that cultural differences or different risk factors affect the expression of the disorder.

Adolescent↗