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PubMed1998

Postnatal foraging demands alter adrenocortical activity and psychosocial development.

Mother squirrel monkeys stop carrying infants at earlier ages in high-demand (HD) conditions where food is difficult to find relative to low-demand (LD) conditions. To characterize these transitions in psychosocial development, from 10- to 21-weeks postpartum we collected measures of behavior, adrenocortical activity, and social transactions coded for initiator (mother or infant), goal (make-contact or break-contact), and outcome (success or failure). Make-contact attempts were most often initiated by HD infants, but mothers often opposed these attempts and less than 50% were successful. Break-contact attempts were most often initiated by LD infants, but mothers often opposed these attempts and fewer LD than HD infant break-contact attempts were successful. Plasma levels of cortisol were significantly higher in HD than LD mothers, but differences in adrenocortical activity were less consistent in their infants. HD and LD infants also spent similar amounts of time nursing on their mothers and feeding on solid foods. By rescheduling some transitions in development (carry-->self-transport), and not others (nursing-->self-feeding), mothers may have partially protected infants from the immediate impact of an otherwise stressful foraging task.

Analysis of Variance↗
PubMedDate not supplied

Childhood history of abuse and child abuse screening.

Although a childhood history of abuse is related to parental child abuse, many parents with a history of abuse are not abusive. To determine the effects of a childhood history of abuse on adult child abuse potential, a modified Conflict Tactics Scale (CTS) and the Child Abuse Potential (CAP) Inventory were administered to matched groups of physically abusive mothers with a childhood history of abuse, nonabusive comparison mothers with a childhood history of abuse, and nonabusive comparison mothers without a childhood history of abuse. The modified CTS asked about childhood events and was used to confirm a childhood history of abuse. As expected, the CTS verbal and violence scales were higher for the abusive and nonabusive mothers with a childhood history of abuse. None of the CTS scores were different for the abusive and nonabusive mothers with a childhood history of abuse. In contrast, the CAP abuse scores distinguished between all three study groups. However, on the CAP factor scales, only the rigidity and unhappiness factors discriminated between abusive and nonabusive mothers with a childhood history of abuse. Nonabusive mothers with a childhood history of abuse were less rigid in their child expectations and were happier in their interpersonal relationships than abusive mothers with a childhood history of abuse.

Adult↗
PubMed2007

The gendered nature of filial piety--a study among Chinese Canadians.

This paper examines the modern face of filial piety enactment among Chinese families living away from their homeland. It empirically assesses filial piety practices among a random sample of diasporic Chinese Canadians, by studying the role of sons, daughters and spouses in providing assistance with basic activities of daily living, instrumental activities of daily living and perceptions of support; the relative contribution of the traditional Chinese caring unit (son plus daughter-in-law) with assistance provided; whether source of assistance changes when amount of care is taken into account, when the gendered nature of tasks is taken into account and when controlling for other factors in multivariate analyses. N = 2,272 Chinese seniors (age 55+) living in seven cities across Canada. The findings reveal that, among these diasporic Chinese, patterns found in other Chinese societies are evident in their tendency to live with children, even when the spouse is still living, and the involvement of sons and the son/daughter-in-law unit in providing care. However, similar to recent findings for China, daughters and spouses are involved in all 3 areas of support examined and importantly, their involvement increases as more assistance is provided while that from sons decreases, notably in terms of IADL. The participation of daughters-in-law tends to be lower than that of either sons or daughters. The involvement of spouses increases for perceived or emotional support. The findings suggest a blending of Chinese and Canadian patterns of care and are discussed in terms of the changing but still gendered nature of care.

Activities of Daily Living↗
PubMed2006

Deficits in perceptions of oral health relative to general health in populations.

OBJECTIVE: To compare perceptions of general health versus oral health within two populations. METHODS: Secondary analysis of cross-sectional survey data obtained from representative samples of dentate adults in Australia and the United States. Australian data were collected in the 2002 National Dental Telephone Interview Survey and United States data were from the NHANES, 1988-1994. A stratified analysis compared self-ratings of general and oral health among groups classified by age, socioeconomic status and access to dental care. RESULTS: In Australia, 43.6% rated their dental health 'very good' or 'excellent' whereas 58.6% rated their general health 'very good' or 'excellent'--a deficit of 15.0%. In the US, there was a comparable deficit of 24.2%. The deficit could be explained as a 'generation gap' where oral health ratings of the youngest cohort resembled the general health ratings of middle-aged adults in Australia and retirees in the US. An 'affluence gap' was evident where the oral health ratings of wealthier adults resembled the general health ratings of disadvantaged adults. Among Australians with private dental insurance who had visited a dentist in the past year the oral health deficit was negligible. Similar stratification in the US sample considerably attenuated the deficit. CONCLUSION: There is a deficit in perceived oral health compared with general health at all stages of adulthood and spanning the socioeconomic spectrum. The deficit was diminished among insured adults who had made a dental visit within the preceding year, suggesting that improved access to dental services may help redress the discrepancy.

Adolescent↗
PubMed2004

Follow-up quality of life assessment in patients after head and neck surgery as evaluated by lay caregivers.

OBJECTIVE/HYPOTHESIS: As rehabilitation after head and neck surgery is increasingly dependent upon caregivers with no formal training (lay caregivers), the lay caregiver's assessment of the patient's quality of life (QOL) status may be critical to successful rehabilitative efforts. This study evaluates lay caregiver QOL assessment at six and 12 months post-operatively and compares the findings to pre-operative assessments. MATERIALS AND METHODS: Twenty-five patients undergoing head and neck surgery and their primary lay caregivers completed the Medical Outcomes Survey Short Form 36 (SF-36) pre-operatively and were followed. Six and 12-month post-operative forms were completed and compared for available patient/lay caregiver pairs. Pair assessment was considered congruent if the lay caregiver's assessment of each domain of the SF-36 fell within the 90th % confidence interval of the patient's score. High congruence was defined as congruence between the pairs for six or more of the eight domains. Results were also related to previously published preoperative data. RESULTS: Fourteen and six patient/lay caregiver pairs completed the six and 12-month follow-up forms, respectively. Overall congruence was 55% and 45% at six and 12 months, respectively, down from 70% found pre-operatively. Forty-two percent and 17% of the patient/lay caregiver pairs were highly congruent at six and 12 months, respectively. Both values were below the 60% high congruence value noted pre-operatively. The trend toward lay caregivers underrating general health was maintained, while overrating of bodily pain leveled at six months and returned at 12 months. Same generation pairs demonstrated a steady decrease in high congruence levels at six and 12 months. Recurrent disease status no longer predicted high congruence at six or 12 months. CONCLUSION: Trends predicting high congruence in patient/lay caregiver QOL assessment identified preoperatively were not maintained in the post-operative evaluations, except the underrating of patients' general health status. Lay caregiver ability to accurately assess patient QOL status did not improve and, in fact, appeared to worsen. Further study into lay caregiver assessment of patients' quality of life status following head and neck surgery is warranted. Efforts should be directed toward the use of standardized assessment tools and anticipation of subject dropout with greater subject recruitment.

Aged↗
PubMed1994

Biodemographic and sociocultural factors in two generations of families from six Polish rural and urban populations.

There were investigated 6967 families from 6 rural regions, under industrialization, and industrialized urban regions. In the grandparents generation there were taken into account 10 traits (an education level, a mating radius, and a stature) and in parents generation 17 traits (the mentioned-above ones and a number of family members, a flat size, incomes, an employees No., a life mode, smoking etc. Numerical characteristics of traits have been calculated jointly and separately in six populations, matrices of correlation have been constructed and moreover factorial analysis have been carried out, as a result of which 8 rotated factors have been obtained. The highest cultural mobility (increase in the level of education) from generation to generation occurs in the population of textile industry town Lódź. The highest improvement of biological status, the increase in mating radius and high incomes are characteristic for this regions, too. On the other side are villages with low culture mobility (not large increase in education level), slight improvement of biological status, almost no migrations, overcrowded flats and low income per family member. The relations between pairs of traits appear to vary largely in several populations. Generally is a high correlation between the education level of the same family members in both generations. The has been stated negative correlation between grandfather stature both of the mother and the father lines, with occurring of positive assortative mating in the couples of two generations. In both investigated generations there is the positive assortative mating, but the negative correlation in the stature between grandfathers of the mother and the father lines. The grandparents education level is correlated with their and their offsprings stature. The duration of holidays is one of the best (closely correlated with others) indicators of life mode, and partially of a given family living conditions, too. 8 hidden factors have been separated: a consciousness, mode of life, a number of family members, a genetic factor (stature), migrations, living conditions, incomes. This 8 factors have different ranks (evaluated as a position in sequence expressing in % the share in being explained variance) in six investigated rural and urban populations, explaining together 54-55% of the total variance of analyzed family traits. The consciousness occurs generally as a first factor. As far, as the mode of life is concerned, the rank of its factor is less in villages than in towns, and reciprocally the ranks of such factors as a number of family members, migrations and living conditions, are greater in villages than in towns.

Adult↗
PubMed1996

Nutrition knowledge and attitudes towards high-fat foods and low-fat alternatives in three generations of women.

OBJECTIVES: To assess family resemblance in food habits in three generations of maternally related family members. DESIGN AND SUBJECTS: Ninety-seven adult women, their mothers and grandmothers were asked about nutrition knowledge, attitudes and fat intake. Nutrition knowledge and attitudes were determined by means of a self-administered questionnaire. A food frequency questionnaire was used to assess fat intake. RESULTS: Mean percentage energy derived from fat was 39% for the younger generation, and 40% for their mothers and grandmothers. Generations differed in their nutrition knowledge score (P <0.0001), the grandmothers having a lower nutrition knowledge than the other generations. Correlations of nutrition knowledge scores were 0.30 (95% confidence limits (c.l.) 0.10 and 0.48) between the younger and middle generations, 0.35 (95% c.l. 0.16 and 0.52) between the middle and older generations, and 0.14 (95% c.l. -0.06 and 0.34) between the younger generation and their grandmothers. For attitudes towards high-fat foods and their low-fat alternatives these figures were 0.27 (95% c.l. 0.07 and 0.45), 0.22 (95% c.l. 0.01 and 0.41), and 0.17 (95% c.l. - 0.03 and 0.36), respectively, while for energy percentage of fat intake the correlations were only 0.19 (95% c.l. -0.01 and 0.37), -0.02 (95% c.l. -0.22 and 0.18), and 0.12 (95% c.l. limits - 0.08 and 0.31), respectively. Within generations the correlations between attitudes and nutrition knowledge or percentage energy derived from fat were found to be higher in the middle generation than in other generations. No statistically significant correlations were found between nutrition knowledge and percentage energy derived from fat. CONCLUSIONS: From this study it can be concluded that mothers and their adult daughters resemble each other in nutrition knowledge and attitudes.

Adult↗
PubMed2002

Are all grandmothers equal? A review and a preliminary test of the "grandmother hypothesis" in Tokugawa Japan.

An unresolved question arising from human evolutionary research relates to the function of the postreproductive period in human females. If menopause is not merely an artifact resulting from the benefits of civilization, there must be an adaptive mechanism favoring the offspring of women who continue to thrive well past the time of their last ovulation. The "grandmother hypothesis" was developed on the basis of the original suggestion by Williams (1957 Evolution 11:32-39) that "stopping early" would benefit already-born children. This idea, combined with the concepts of kin selection (Hamilton 1964 J Theor Biol 7:1-52) and parental investment (Trivers 1972 Sexual Selection and the Descent of Man, Chicago: Aldine, p. 136-179), was expanded to suggest that postreproductive women (in contrast to males) contribute to their inclusive fitness by extending support to their grandchildren. We used discrete time event history analysis (Allison [1984] Event History Analysis, Newbury Park: Sage; Allison [1995] Survival Analysis, Cary, NC: SAS Institute) and logistic regression on data provided in population registers (Shūmon Aratame Chō, or SAC) from a village in central Japan, covering the period from 1671-1871, in a preliminary investigation of the effects of household grandparental presence on the probability of a child's death. We found that after accounting for the presence of other household members, the only grandparent whose presence exerted a consistent negative effect on the likelihood of a child's death was the mother's mother. Due to the small sample size of households that contained maternal grandmothers, these results failed to achieve statistical significance. Their importance, however, is in what they suggest about future research, i.e., census data from preindustrial societies can provide a basis for testing evolutionary proposals, including the "grandmother hypothesis."

Adaptation, Physiological↗
PubMed2004

A feasibility study of an intervention to enhance family support for breast feeding in a deprived area in Bristol, UK.

OBJECTIVE: to assess fathers' and grandmothers' knowledge of breast feeding and their ability to support successful breast feeding. To design a suitable intervention for fathers and grandmothers to support breast-feeding mothers, to assess the acceptability and feasibility of the intervention and monitor its likely effects on breast-feeding rates. DESIGN: qualitative focus groups and interviews. Evaluation of the feasibility of an antenatal intervention. SETTING: Community Health Centre and family homes in an area of relative social and economic deprivation in South Bristol, UK, from November 2001 to May 2003. PARTICIPANTS: 10 grandmothers and five fathers in focus groups and interviews. Twenty-nine families in the intervention. INTERVENTION: an antenatal intervention for grandmothers or partners to support breast feeding, which combined the benefits and mechanics of breast feeding with ways of providing support for breast feeding. FINDINGS: using an antenatal session based around a leaflet, specifically written for grandmothers and partners, and including a demonstration of good breast-feeding positioning and attachment in addition to the discussion of specific issues around the health benefits and mechanics of breast feeding was found to be acceptable, useful and enjoyable by all participants, particularly for first-time parents. The importance of fathers and grandmothers in providing emotional and practical support for breast-feeding mothers is highlighted, since those who were still breast feeding at eight weeks all felt that they were receiving similar or better support postnatally than they were antenatally. Significantly more intervention mothers were breast feeding their babies at eight weeks than in the wider practice population of mothers outside the study who intended to breast feed. Fathers' attitudes to breast feeding postnatally were fairly similar to those before the baby was born with breast feeding in public and knowing how much milk the baby was getting having the most influence on whether they felt that their partner should continue to breast feed. IMPLICATIONS FOR PRACTICE: this type of intervention could be part of a multi-faceted approach towards improving breast-feeding initiation and continuation, particularly in areas of low prevalence. Health professionals should be opportunistic about involving other family members in discussions about breast feeding whenever possible, both antenatally and postnatally.

Adult↗
PubMed2006

Mind the gap.

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Adult↗
PubMed1994

Sexual abuse, adolescent pregnancy, and child abuse. A developmental approach to an intergenerational cycle.

OBJECTIVE: To elucidate the relationship between childhood sexual abuse and adolescent pregnancy. DATA SOURCE: Articles published in English during the past two decades and pertaining to the sequelae of childhood sexual abuse or the antecedents of adolescent pregnancy. STUDY SELECTION: Studies that did not contain data pertinent to the relationship between childhood sexual abuse and adolescent pregnancy were excluded. RESULTS: Studies suggest that former victims of childhood sexual abuse may be at increased risk for conception during adolescence and that adolescent pregnancies that are antedated by childhood sexual abuse are often only one manifestation of socially deviant behavior. CONCLUSIONS: Experiences associated with childhood sexual abuse may affect the incidence and the outcome of adolescent childbearing. Identification and treatment of previously abused adolescent prenatal patients may break this vicious intergenerational cycle of violence.

Adolescent↗
PubMed2002

The generation gap in modern surgery: a new era in general surgery.

General surgery remains one of the most respected residencies available to medical students today. At the same time, the number of medical school graduates applying for general surgery residencies continues to decline. Despite this decline, we still search for those individuals exhibiting qualities shared by general surgeons who excel. Although the field of general surgery is constantly evolving, these qualities remain the same. While intellect and good technical skills are essential, they alone do not ensure success as a surgery resident. Confidence, stamina, tenacity, and patience are imperative. Good leadership, motivational, and decision-making skills are also vital characteristics. Finally, the importance of dedication to patient care cannot be overstated. Because disease, injury, and pain are not scheduled events, general surgery residents regularly spend long hours, day and night, caring for and worrying about their patients. To ensure that we continue to add a sufficient number of general surgery residents each year without lowering our standards, those of us in general surgery must attempt to determine why fewer medical school graduates are applying for general surgery residencies. Then we must find ways in which we can improve the residency programs and, probably more important, emphasize to students the things about this field that led us to devote our lives to its practice.

General Surgery↗
PubMed2002

The X generation.

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General Surgery↗