Family Members (family + member)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Family Members

  • adult family member
  • affected family member
  • asymptomatic family member
  • bcl-2 family member
  • close family member
  • extended family member
  • first-degree family member
  • healthy family member
  • multiple family member
  • new family member
  • other family member
  • patient family member
  • protein family member
  • receptor family member
  • several family member
  • unaffected family member

  • Terms modified by Family Members

  • family member perception

  • Selected Abstracts

    Care for the Adult Family Members of Victims of Unexpected Cardiac Death

    Robert Zalenski MD
    Abstract More than 300,000 sudden coronary deaths occur annually in the United States, despite declining cardiovascular death rates. In 2000, deaths from heart disease left an estimated 190,156 new widows and 68,493 new widowers. A major unanswered question for emergency providers is whether the immediate care of the loved ones left behind by the deceased should be a therapeutic task for the staff of the emergency department in the aftermath of a fatal cardiac arrest. Based on a review of the literature, the authors suggest that more research is needed to answer this question, to assess the current immediate needs and care of survivors, and to find ways to improve care of the surviving family of unexpected cardiac death victims. This would include improving quality of death disclosure, improving care for relatives during cardiopulmonary resuscitation of their family member, and improved methods of referral for services for prevention of psychological and cardiovascular morbidity during bereavement. [source]

    Proposed Standard Nomenclature for New Tumor Necrosis Factor Family Members Involved in the Regulation of Bone Resorption ,

    Article first published online: 1 DEC 2000
    Abstract Recently, three new family members of the tumor necrosis factor (TNF) ligand and receptor signaling system that play a critical role in the regulation of bone resorption have been identified and cloned. These also have been shown to play an important role in regulating the immune system. A proliferation of synonyms for these molecules has led to miscommunication and redundancy. To resolve this, the President of the American Society for Bone and Mineral Research (ASBMR) appointed a special committee to recommend a standard nomenclature. After considerable deliberation and after vetting by workers in the field, the Committee recommends the names of receptor activator of NF-,B (RANK) for the membrane receptor, RANK ligand (RANKL) for the ligand, and osteoprotegerin (OPG) for the decoy receptor. [source]

    Symposium 1: Regulation of Neural Development by BMP and Activin Family Members

    J. A. Kessler
    The effects of BMP family members on stem cell lineage commitment depend upon the developmental age of the stem cell. BMP4 promotes apoptosis of early ventricular zone (VZ) stem cells, neuronal differentiation of later stage VZ cells, and astroglial differentiation of subventricular zone (SVZ) cells. BMP4 inhibits oligodendroglial lineage commitment at all stages of development. The effects of BMP4 in promoting commitment to a specific lineage reflect active suppression of alternate lineages by transcriptional inhibitors including ID and HEY family members and others. For example, BMP mediated increases in ID expression in SVZ stem cells suppress both oligodendroglial and neuronal differentiation. Similarly HEY 1 expression in SVZ cells suppresses neuronal differentiation, whereas HEYL expression by VZ cells inhibits glial differentiation and promotes neurogenesis. The differing effects of the BMPs on VZ and SVZ stem cells reflect also differences in the complement of transcription factors that are expressed. For example, VZ stem cells express high levels of neurogenin and HEY L whereas SVZ stem cells express lower levels of these factors but higher levels of HEY1. Thus lineage commitment by stem cells reflects interplay among stimulatory and inhibitory transcription factors, and responses to the BMPs depend upon the repertoire of transcription factors already expressed by the cell. [source]

    Traumatic Events Involving Friends and Family Members in a Sample of African American Early Adolescents

    Esther J. Jenkins PhD
    The current study examines violent and nonviolent traumatic events involving friends and family members as predictors of PTSD, depression, internalizing, and externalizing behaviors in a sample of 403 African American early adolescents from chronically violent environments. Although there are many studies of urban children's exposure to community violence, few address the unique contribution of events involving significant others, and almost no research addresses African American youths' exposure to traumatic events other than violence. This study found that violent and nonviolent traumatic events were pervasive in the lives of these urban youth, and that they were as likely to report loss and injury of a close other through an accident as an act of violence. There were strong gender differences in the data. Unexpectedly, injury or loss of a close friend or family member from nonviolent events, but not from violent events, predicted PTSD, internalizing, and depression for boys. The results are discussed in terms of their implications for school-based universal interventions in communities where large numbers of children live with loss and trauma. [source]

    Molecular Characteristics And Functional Diversity Of Clca Family Members

    Bendicht U Pauli
    SUMMARY 1. In the present brief review, we describe some of the molecular and functional characteristics of a novel mammalian family of putative Ca2+ -activated chloride channels (CLCA). 2. So far, two bovine (bCLC1; bCLCA2 (Lu-ECAM-1)), three mouse (mCLCA1; mCLCA2; mCLCA3) and four human (hCLCA1; hCLCA2; hCLCA3; hCLCA4) CLCA family members have been cloned. Each CLCA exhibits a distinct, often overlapping, tissue expression pattern. 3. With the exception of the truncated secreted hCLCA3, all CLCA proteins are synthesized as an approximately 125 kDa precursor transmembrane glycoprotein that is rapidly cleaved into 90 and 35 kDa subunits. 4. The CLCA proteins expressed on the luminal surface of lung vascular endothelia (bCLCA2; mCLCA1; hCLCA2) serve as adhesion molecules for lung metastatic cancer cells, mediating vascular arrest and lung colonization. 5. Expression of hCLCA2 in normal mammary epithelium is consistently lost in human breast cancer and in all tumorigenic breast cancer cell lines. Re-expression of hCLCA2 in human breast cancer cells abrogates invasiveness of Matrigel (BD Biosciences-Labware, Bedford, MA, USA) in vitro and tumorigenicity in nude mice, implying that hCLCA2 acts as a tumour suppressor in breast cancer. [source]

    Individuals receiving addiction treatment: are medical costs of their family members reduced?

    ADDICTION, Issue 7 2010
    Constance Weisner
    ABSTRACT Aims To examine whether alcohol and other drug (AOD) treatment is related to reduced medical costs of family members. Design Using the administrative databases of a private, integrated health plan, we matched AOD treatment patients with health plan members without AOD disorders on age, gender and utilization, identifying family members of each group. Setting Kaiser Permanente Northern California. Participants Family members of abstinent and non-abstinent AOD treatment patients and control family members. Measurements We measured abstinence at 1 year post-intake and examined health care costs per member-month of family members of AOD patients and of controls through 5 years. We used generalized estimating equation methods to examine differences in average medical cost per member-month for each year, between family members of abstinent and non-abstinent AOD patients and controls. We used multilevel models to examine 4-year cost trajectories, controlling for pre-intake cost, age, gender and family size. Results AOD patients' family members had significantly higher costs and more psychiatric and medical conditions than controls in the pre-treatment year. At 2,5 years, each year family members of AOD patients abstinent at 1 year had similar average per member-month medical costs to controls (e.g. difference at year 5 = $2.63; P > 0.82), whereas costs for family members of non-abstinent patients were higher (e.g. difference at year 5 = $35.59; P = 0.06). Family members of AOD patients not abstinent at 1 year, had a trajectory of increasing medical cost (slope = $10.32; P = 0.03) relative to controls. Conclusions Successful AOD treatment is related to medical cost reductions for family members, which may be considered a proxy for their improved health. [source]

    Family members of people with alcohol or drug dependence: health problems and medical cost compared to family members of people with diabetes and asthma

    ADDICTION, Issue 2 2009
    G. Thomas Ray
    ABSTRACT Aims To compare the medical costs and prevalence of health conditions of family members of people with an alcohol or drug dependence (AODD) diagnosis to family members of people with diabetes and asthma. Setting Kaiser Permanente of Northern California (KPNC). Participants Family members of people diagnosed with AODD between 2002 and 2005, and matched samples of family members of people diagnosed with diabetes and asthma. Measurements Logistic regression was used to determine whether the family members of people with AODD were more likely to be diagnosed with medical conditions than family members of people with diabetes or asthma. Multivariate models were used to compare health services cost and utilization of AODD family members and diabetes and asthma family members. Analyses were for the year before, and 2 years following, initial diagnosis of the index person. Findings In the year before initial diagnosis of the index person, AODD family members were more likely to be diagnosed with substance use disorders, depression and trauma than diabetes or asthma family members. AODD family members had higher total health-care costs than diabetes family members in the year following, and the second year following, the index date ($217 and $293, respectively). AODD family members had higher total health-care costs than asthma family members in the year before, and second year following, the index date ($104 and $269, respectively). Conclusions AODD family members have unique patterns of health conditions compared to the diabetes and asthma family members and have similar, or higher, health-care cost and utilization. [source]

    Social Networks and Entrepreneurship

    Arent Greve
    We study network activities of entrepreneurs through three phases of establishing a firm in four countries. Entrepreneurs access people in their networks to discuss aspects of establishing and running a business. We find that entrepreneurs build networks that systematically vary by the phase of entrepreneurship, analyzing number of their discussion partners, and the time spent networking. Entrepreneurs talk with more people during the planning than other phases. Family members are present in their networks in all phases, particularly among those who took over an existing firm. However, women use their kin to a larger extent than men, and even more than men when they take over an existing firm. Experienced entrepreneurs have the same networking patterns as novices. Moreover, these networking patterns are the same in all countries. However, there are country differences in size of discussion networks and time spent networking. [source]

    Sodium channel SCN1A and epilepsy: Mutations and mechanisms

    EPILEPSIA, Issue 9 2010
    Andrew Escayg
    Summary Mutations in a number of genes encoding voltage-gated sodium channels cause a variety of epilepsy syndromes in humans, including genetic (generalized) epilepsy with febrile seizures plus (GEFS+) and Dravet syndrome (DS, severe myoclonic epilepsy of infancy). Most of these mutations are in the SCN1A gene, and all are dominantly inherited. Most of the mutations that cause DS result in loss of function, whereas all of the known mutations that cause GEFS+ are missense, presumably altering channel activity. Family members with the same GEFS+ mutation often display a wide range of seizure types and severities, and at least part of this variability likely results from variation in other genes. Many different biophysical effects of SCN1A -GEFS+ mutations have been observed in heterologous expression systems, consistent with both gain and loss of channel activity. However, results from mouse models suggest that the primary effect of both GEFS+ and DS mutations is to decrease the activity of GABAergic inhibitory neurons. Decreased activity of the inhibitory circuitry is thus likely to be a major factor contributing to seizure generation in patients with GEFS+ and DS, and may be a general consequence of SCN1A mutations. [source]

    Family members of relatives with alcohol, drug and gambling problems: a set of standardized questionnaires for assessing stress, coping and strain

    ADDICTION, Issue 11 2005
    Jim Orford
    ABSTRACT Aims To describe a set of standard questionnaire measures for the assessment of the needs of family members of relatives with alcohol, drug or gambling problems, and to present evidence of their reliability and validity from a series of related studies. Design Includes cross-sectional and repeated-measurement studies. Setting and participants Family members affected by and concerned about the problem drinking or drug-taking of close relatives in treatment and non-treatment samples in the United Kingdom (white and Sikh) and Mexico City; family members of untreated heavy drinkers; and family members of problem gamblers. Measurements Four measures derived from a stress,strain,coping,support model of alcohol, drugs and gambling problems and the family: Family Member Impact scale (FMI), Symptom Rating Test (SRT), Coping Questionnaire (CQ), and Hopefulness,Hopelessness scale (HOPE). FMI, SRT and CQ assess stress, strain and coping, respectively. The exact role of HOPE in the model remains to be determined. The support component remains unmeasured. Findings Results from a number of studies support the internal reliability, discriminant and construct validity and sensitivity to change of the SRT and its two constituent scales (psychological and physical symptoms) and at least two subscales of the CQ (engaged and tolerant,inactive coping). Although showing evidence of satisfactory reliability and some evidence of discriminant validity, further work may be required on the CQ withdrawal coping subscale. Evidence suggests that the FMI is reliable and valid and may have a factor structure that will support future research (distinguishing worrying behaviour from active disturbance). HOPE is a new measure showing promising characteristics. Conclusions A set of standard measures is available for helping to assess the needs of concerned and affected family members, derived from an explicit model of the family in relation to excessive drinking, drug taking or gambling. It may have a role to play in correcting the current neglect of the needs of such family members, estimated to be in the region of nearly a million adults in Britain alone. [source]

    Interest in genetic testing in pallido-ponto-nigral degeneration (PPND): a family with frontotemporal dementia with Parkinsonism linked to chromosome 17

    C. A. McRae
    The specific mutation on the tau gene responsible for a neurodegenerative disease known as pallido-ponto-nigral degeneration (PPND) was recently located. PPND family members are at risk for an autosomal dominant form of frontotemporal dementia with Parkinsonism linked to chromosome 17 (FTDP-17). This study investigated whether individuals in this family would consider presymptomatic genetic testing. Surveys were sent to 66 at-risk individuals in the family; replies were received from 20 (30%). Family members were asked if they would consider having testing now or in the future, and to indicate their reasons for and against proceeding with testing. Fifty per cent (n=10) of those who were at risk and who responded indicated they would consider testing now, and 55% (n=11) would think about it in the future. The most frequently cited reasons to proceed with testing were to ,collaborate with research' (70%) and to ,know if my children are at risk' (45%). The most frequently cited reason not to pursue testing was ,I can enjoy my life more fully by not knowing' (50%). Results suggest that interest in determining whether they will manifest PPND is generally low among at-risk members of this family, despite wide support and participation in other research studies. [source]

    What are patients and their families told about the diagnosis of dementia?

    Results of a family survey
    Abstract Background Controversy exists as to whether dementia patients should be told their diagnosis and prognosis. Objective This study examined the experience of patients and families when a diagnosis of dementia is given. Method Fifty-seven family members from community dementia support groups answered a questionnaire regarding the diagnosis of dementia in a family member. Results Family members were significantly more likely to have been told the diagnosis and symptoms to expect in dementia than patients themselves. Half of the families felt they were not given enough information regarding dementia. Interestingly, the majority of family members believed patients should be told their diagnosis and prognosis yet about half had reported that informed patients had reacted poorly to being told their diagnosis and only about a third felt it was helpful to the patient. Conclusion The results suggest physicians should better involve patients and their families in disclosing diagnoses and information regarding dementia. The results also suggest the current AMA guidelines to inform patients their diagnosis of dementia are inadequate to address the clinical complexities of this issue. Copyright © 2002 John Wiley & Sons, Ltd. [source]

    How Should Clinicians Describe Hospice to Patients and Families?

    David J. Casarett MD
    Objectives: To describe hospice enrollment from the perspective of bereaved family members and to identify information about hospice that would encourage patients and families to enroll sooner. Design: Cross-sectional interviews. Setting: Three Medicare-certified hospice organizations. Participants: One hundred family members of 100 patients who died in hospice. Measurements: Semistructured interviews assessed prior knowledge of hospice, patients' and physicians' involvement in the enrollment process, features of hospice that motivated enrollment, and features that patients and families wished they had learned about sooner. Results: Almost all family members (n=92) and patients (n=71) knew about hospice before the patient's illness. Almost half the patients (n=44) were not involved at all in the hospice enrollment decision. The patient's physician (n=51) or the patient or family (n=34) initiated most hospice discussions, but patients and families usually obtained information about hospice from a hospice representative (n=75) rather than from the patient's physician (n=22). Family members identified several kinds of information about hospice that were particularly helpful in deciding whether to enroll and described several aspects of hospice that they wished they had known about sooner. Conclusion: Many patients and families learn about hospice from someone other than the patient's physician, and most learn about valuable hospice features and services only after enrollment. By providing more information about hospice earlier in the illness course, clinicians may be able to facilitate more-informed and more-timely decisions about hospice enrollment. [source]

    Sp1 and krüppel-like factor family of transcription factors in cell growth regulation and cancer

    Adrian R. Black
    The Sp/KLF family contains at least twenty identified members which include Sp1-4 and numerous krüppel-like factors. Members of the family bind with varying affinities to sequences designated as ,Sp1 sites' (e.g., GC-boxes, CACCC-boxes, and basic transcription elements). Family members have different transcriptional properties and can modulate each other's activity by a variety of mechanisms. Since cells can express multiple family members, Sp/KLF factors are likely to make up a transcriptional network through which gene expression can be fine-tuned. ,Sp1 site'-dependent transcription can be growth-regulated, and the activity, expression, and/or post-translational modification of multiple family members is altered with cell growth. Furthermore, Sp/KLF factors are involved in many growth-related signal transduction pathways and their overexpression can have positive or negative effects on proliferation. In addition to growth control, Sp/KLF factors have been implicated in apoptosis and angiogenesis; thus, the family is involved in several aspects of tumorigenesis. Consistent with a role in cancer, Sp/KLF factors interact with oncogenes and tumor suppressors, they can be oncogenic themselves, and altered expression of family members has been detected in tumors. Effects of changes in Sp/KLF factors are context-dependent and can appear contradictory. Since these factors act within a network, this diversity of effects may arise from differences in the expression profile of family members in various cells. Thus, it is likely that the properties of the overall network of Sp/KLF factors play a determining role in regulation of cell growth and tumor progression. © 2001 Wiley-Liss, Inc. [source]

    Metasynthesis: withdrawing life-sustaining treatments: the experience of family decision-makers

    Mary Ann Meeker
    Aim., The present study was undertaken to synthesise findings from qualitative investigations of family participation in decisions to withdraw and/or withhold life-sustaining treatment from a seriously ill family member. Background., As a consequence of increasing effectiveness and sophistication of available medical interventions, death is commonly preceded by a decision to withdraw or withhold potentially life-sustaining treatments. These decisions take place in a bioethical context characterised by the preeminence of self-determination, but patients are typically too ill to make their own decisions. Thus, family members are called upon to participate in these morally consequential decisions on the patient's behalf. Design., Metasynthesis Method., Metasynthesis is a form of inquiry that provides for integration of qualitative studies' findings to strengthen knowledge for practice and advance theoretical development. This metasynthesis was conducted using the constant comparative methods of grounded theory. Results., Family members engage in a process of participation in decision-making that is comprised of three major categories: reframing reality, relating and integrating. Surrogates used both cues and information as they reframed their understanding of the patient's status. Relationships with providers and with other family members powerfully influenced the decision-making process. Integrating was characterised by reconciling and going forward. This part of the process has both intrapersonal and interpersonal aspects and describes how family decision-makers find meaning in their experience and move forward in their lives. Conclusions., This synthesis provides a more comprehensive and empirically supported understanding of family members' experiences as they participate in treatment decisions for dying family members. Relevance to clinical practice., This metasynthesis provides evidence to improve family care during treatment withdrawal/withholding decision-making and a theoretical model that can be used to guide creation of clinical practice guidelines. Through increased understanding of family members' experiences, clinicians can more effectively support family decision-making processes. [source]

    Communication Privacy Management Theory: What Do We Know About Family Privacy Regulation?

    Sandra Petronio
    For families, managing private information is challenging. Family members reveal too much, they allow more privacy access to outsiders than others desire, parents attempt to negotiate Internet disclosures with their teens, and family health issues often change the way private information is defined altogether. The complexities of privacy regulation call for a systematic way to grasp how privacy management operates in families. This article presents the evidenced-based theory of communication privacy management (CPM) and corresponding research on family privacy regulation that provides a road map to understand the multifaceted nature of managing private information (Petronio, 2002). The article discusses contributions of CPM to conceptualizing privacy in meaningful ways, along with current research trends and future directions for CPM research and theorizing. [source]

    Family Network Support and Mental Health Recovery

    Francesca Pernice-Duca
    Family members often provide critical support to persons living with a serious mental illness. The focus of this study was to determine which dimensions of the family support network were most important to the recovery process from the perspective of the recovering person. Consumers of a community mental health program completed in-depth structured interviews that included separate measures of social network support and recovery. Consumers named an average of 2.6 family members on the social network, interacted with family on a weekly basis, and were quite satisfied with their contact. This study revealed that support and reciprocity with family members are important dimensions of a personal support network that relates to the recovery process. [source]

    Perinatal and intrafamily transmission of hepatitis B virus in three generations of a low-prevalence population

    Katalin Ördög
    Abstract Family members of 47 hepatitis B virus (HBV)-carrier pregnant women were tested for the presence of hepatitis B surface antigen (HBsAg), other markers of HBV infection, and hepatitis A virus (HAV) antibodies. Eleven members of six families were found to be HBV DNA positive. Five of the anti-HBe-positive persons were found to be HBV DNA carriers, too. The mean age of the HBV DNA carriers was found to be lower than that of Hbe carriers; therefore, it is suggested that seroconversion to HBe occurs before the resolution of HBV DNA carrier state. Superinfection with hepatitis A virus was not found to influence the elimination of HBV-carrier state, as there was no correlation found between the hepatitis A exposure and the hepatitis B virus markers in the families. The low HBV prevalence in the population (0.3%) was in contrast to the high prevalence of the families of the HBV-carrier mothers (27.1%) and family members with HBV markers (50.4%). Significant positive correlation was found in the proportion of HBV-positive children, and the HBV history of their parents. When fathers were shown to be seronegative, the probability of HBV transmission was reduced by a factor of 6 (12.5% instead of 75%) probably due to reduced viral load and possibly by other factors. Several results indicate, that the noncytocidal hepatitis B virus clearing mechanism suggested by Guidotti et al. [1996, 1999] was effective also in the HBV-carrier human population. J. Med. Virol. 70: 194,204, 2003. © 2003 Wiley-Liss, Inc. [source]

    Personality Judgments in Adolescents' Families: The Perceiver, the Target, Their Relationship, and the Family

    Susan J. T. Branje
    The present study investigated whether personality judgments involve different processes in a family setting than in a nonfamily setting. We used the Social Relations Model to distinguish the effects of perceiver, target, perceiver-target relationship, and family on personality judgments. Family members of families with adolescents judged their own and the other members' Big Five factors. Judgments were found to depend on the relevance of personality factors within the family setting: Agreeableness and Conscientiousness were judged most consistently. Large relationship variance indicated that parents adjust their judgments to the target family member; large perceiver variance indicated that adolescents judge family members' personalities rather similarly. However, a comparison of self- and other-judgments showed adolescents' judgments to be no more related to their self-perceptions than parents' judgments. We concluded that the relevance of personality factors may differ on specific tasks within a setting. [source]

    Using systemic reflective practice to treat couples and families with alcohol problems

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    Accessible summary ,,Alcohol services in the UK generally treat clients from an individual medical and psychiatric perspective. Carers, partners, children and other family members are infrequently actively involved in the clients' care process. ,,A reflective family-based approach was introduced in an attempt to improve treatment engagement with drinkers with relatives. Favourable findings from several self-reporting research and evaluation studies are provided and analysed. ,,The use of this intervention was found to be effective in facilitating change in drinking and relationships. Family members when involved in the care management proved to be influential in the behaviour change process. ,,Family group reflecting interventions should be used more extensively and involvement of partners and family members in care programmes should be promoted. Implications for the extended use of the intervention both in addiction settings and wider health and social care practice are discussed. Abstract In the UK, an adult with a drinking problem is generally treated from an individual perspective with minimal involvement of carers and relatives. In response to this gap in service provision, a systemic reflecting intervention was introduced to assist couples and families experiencing alcohol-related difficulties. The article documents the background and development of this initiative. Findings from evaluation and clinical outcome studies are reviewed and demonstrate how the use of the approach proved to be effective in facilitating positive change both in drinking and family behaviour. In conclusion, the paper explores the implications of how systemic reflective practice with family groups may be extended and be usefully used in wider addiction, diverse mental and general health-care settings. [source]

    Characterization of an immunologic polymorphism (D79H) in the heavy chain of factor V

    M. Van Der Neut Kolfschoten
    Summary.,Background: During the study of a family with hereditary factor (F)V deficiency (FV Amersfoort, 1102 A > T in exon 7) we identified an individual with 5% FV heavy chain antigen (FVHC) and 50% FV light chain antigen (FVLC). Further testing revealed that apart from the FV Amersfoort allele a second variant FV allele was segregating in this family, which encodes for a FV molecule with a reduced affinity for mAb V-23 used in the FV heavy chain ELISA (ELISAHC). Objective: Identification and characterization of the molecular basis responsible for the reduced affinity of the variant FV for mAb V-23. Methods: Family members of the proband were screened for mutations in the exons coding for the heavy chain of FV, after which the recombinant variant FV could be generated and characterized. Next, the cases and controls of the Leiden Thrombophilia Study (LETS) were genotyped for carriership of the variant FV. Results: In the variant FV allele a polymorphism in exon 3 (409G > C) was identified, which predicts the replacement of aspartic acid 79 by histidin (D79H). Introduction of this mutation in recombinant FV confirmed that it reduces the affinity for binding to mAb V-23. The substitution has no effect on FV(a) stability and Xa-cofactor activity. In Caucasians the frequency of the FV-79H allele is ,5%. Analysis of the LETS revealed that the FV-79H allele is not associated with FV levels (FVLC), activated protein C sensitivity (using an activated partial thromboplastin time-based test) or risk of venous thrombosis (OR 1.07, CI 95: 0.7,1.7). Conclusion: The D79H substitution in FV should be considered as a neutral polymorphism. The monoclonal antibody V-23, which has a strongly reduced affinity for FV-79H, is not suitable for application in diagnostic tests. [source]

    ,Being appropriately unusual': a challenge for nurses in health-promoting conversations with families

    NURSING INQUIRY, Issue 2 2008
    Eva Gunilla Benzein
    This study describes the theoretical assumptions and the application for health-promoting conversations, as a communication tool for nurses when talking to patients and their families. The conversations can be used on a promotional, preventive and healing level when working with family-focused nursing. They are based on a multiverse, salutogenetic, relational and reflecting approach, and acknowledge each person's experience as equally valid, and focus on families' resources, and the relationship between the family and its environment. By posing reflective questions, reflection is made possible for both the family and the nurses. Family members are invited to tell their story, and they can listen to and learn from each other. Nurses are challenged to build a co-creating partnership with families in order to acknowledge them as experts on how to lead their lives and to use their own expert knowledge in order to facilitate new meanings to surface. In this way, family health can be enhanced. [source]

    Common variable immunodeficiency: 20-yr experience at a single centre

    Ma Pilar Llobet
    Common variable immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency. It can present at any age in patients with a history of recurrent bacterial infections, with or without a family history of other primary immunodeficiencies (PID), and shows a wide range of clinical manifestations and immunological data. Diagnosis is based on low IgG, IgM and/or IgA levels. Delayed diagnosis and therapy can lead to bronchiectasis and malabsorption. The aim of this study was to describe a paediatric population diagnosed of CVID and its evolution in the population. Memory B-cell (MB) classification carried out in these patients was correlated with clinical manifestations and outcome. Clinical and immunological data of 22 CVID children under 18 yr treated at our centre between 1985 and 2005 are presented. Immunological studies included those for diagnosis and MB quantification. Differences in form of presentation, familial incidence and MB classification were reviewed. A statistical descriptive analysis was made. Infections were the commonest manifestation, affecting mainly respiratory (19/22) and gastrointestinal (10/22) tracts. Bronchiectasis was present in seven cases, and detected prior to CVID diagnosis in five. Replacement therapy led to a significant reduction in the number of infections. Severe complications appeared mostly in patients without MB. Patients of the same family share the same MB group. Family members had also been diagnosed of CVID in seven cases. Early diagnosis and therapy are essential to improve outcome in these patients. MB studies are useful in children to orient prognosis and further genetic studies. [source]

    Who Will Consent to Emergency Treatment Trials for Subarachnoid Hemorrhage?

    Angela Del Giudice MD
    Abstract Objectives:, Aneurysmal subarachnoid hemorrhage (SAH) is a devastating disorder that still requires much clinical study. However, the decision to participate in a randomized clinical trial, particularly a neuroemergency trial, is a complex one. The purposes of this survey were to determine who would participate in a randomized clinical trial that intended to examine transfusion practices after SAH, to identify who could serve as potential proxy decision-makers, and to find which patient characteristics were associated with the decision to participate. Methods:, This was a cross-sectional study using a self-administered questionnaire, composed of a brief description of the proposed trial followed by questions about participation using a 5-point Likert scale. Information sought included potential decision-maker, demographic data, setting and reason for current health care access, and personal or family history of neurologic injury. Results:, Nine-hundred five subjects were enrolled during emergency department (ED) visits, office visits, hospital admissions, or online, during a 1-month period: 63% were women and 46% were white. Nonneurologic problems were the leading reason (90%) for health care access, but 45% had a personal or family history of neurologic injury. Overall, 54% (95% confidence interval [CI] = 51% to 57%) of subjects stated they would definitely or probably consent to participate. No subject characteristics were associated with this decision: age (p = 0.28), sex (p = 0.16), race/ethnicity (p = 0.07), education (p = 0.44), religion (p = 0.42), clinical setting (p = 0.14), reason for visit (p = 0.58), and/or history of neurologic injury (p = 0.33). The vast majority (88%) identified a family member as the proxy decision-maker, again without differences among groups. Conclusions:, Greater than half of respondents stated they would participate in a proposed emergency treatment trial for SAH. Our survey suggests that the decision to participate is highly individualized, because no demographic, pathologic, historical, or access-related predictors of choice were found. Educational materials designed for this type of trial would need to be broad-based. Family members should be considered as proxy decision-makers where permitted by federal and local regulations. [source]

    Ectopic calcification among families in the Azores: Clinical and radiologic manifestations in families with diffuse idiopathic skeletal hyperostosis and chondrocalcinosis

    ARTHRITIS & RHEUMATISM, Issue 4 2006
    Jácome Bruges-Armas
    Objective Twelve families that were multiply affected with diffuse idiopathic skeletal hyperostosis (DISH) and/or chondrocalcinosis, were identified on the island of Terceira, The Azores, potentially supporting the hypothesis that the 2 disorders share common etiopathogenic factors. The present study was undertaken to investigate this hypothesis. Methods One hundred three individuals from 12 unrelated families were assessed. Probands were identified from patients attending the Rheumatic Diseases Clinic, Hospital de Santo Espírito, in The Azores. Family members were assessed by rheumatologists and radiologists. Radiographs of all family members were obtained, including radiographs of the dorsolumbar spine, pelvis, knees, elbows, and wrists, and all cases were screened for known features of chondrocalcinosis. Results Ectopic calcifications were identified in 70 patients. The most frequent symptoms or findings were as follows: axial pain, elbow, knee and metacarpophalangeal (MCP) joint pain, swelling, and/or deformity, and radiographic enthesopathic changes. Elbow and MCP joint periarticular calcifications were observed in 35 and 5 patients, respectively, and chondrocalcinosis was identified in 12 patients. Fifteen patients had sacroiliac disease (ankylosis or sclerosis) on computed tomography scans. Fifty-two patients could be classified as having definite (17%), probable (26%), or possible (31%) DISH. Concomitant DISH and chondrocalcinosis was diagnosed in 12 patients. Pyrophosphate crystals were identified from knee effusions in 13 patients. The pattern of disease transmission was compatible with an autosomal-dominant monogenic disease. The mean age at which symptoms developed was 38 years. Conclusion These families may represent a familial type of pyrophosphate arthropathy with a phenotype that includes peripheral and axial enthesopathic calcifications. The concurrence of DISH and chondrocalcinosis suggests a shared pathogenic mechanism in the 2 conditions. [source]

    Short-term Functional Decline and Service Use in Older Emergency Department Patients With Blunt Injuries

    Scott T. Wilber MD
    ACADEMIC EMERGENCY MEDICINE 2010; 17:679,686 © 2010 by the Society for Academic Emergency Medicine Abstract Background:, Injuries are a common reason for emergency department (ED) visits by older patients. Although injuries in older patients can be serious, 75% of these patients are discharged home after their ED visit. These patients may be at risk for short-term functional decline related to their injuries or treatment. Objectives:, The objectives were to determine the incidence of functional decline in older ED patients with blunt injuries not requiring hospital admission for treatment, to describe their care needs, and to determine the predictors of short-term functional decline in these patients. Methods:, This institutional review board,approved, prospective, longitudinal study was conducted in two community teaching hospital EDs with a combined census of 97,000 adult visits. Eligible patients were , 65 years old, with blunt injuries <48 hours old, who could answer questions or had a proxy. We excluded those too ill to participate; skilled nursing home patients; those admitted for surgery, major trauma, or acute medical conditions; patients with poor baseline function; and previously enrolled patients. Interviewers collected baseline data and the used the Older Americans Resources and Services (OARS) questionnaire to assess function and service use. Potential predictors of functional decline were derived from prior studies of functional decline after an ED visit and clinical experience. Follow-up occurred at 1 and 4 weeks, when the OARS questions were repeated. A three-point drop in activities of the daily living (ADL) score defined functional decline. Data are presented as means and proportions with 95% confidence intervals (CIs). Logistic regression was used to model potential predictors with functional decline at 1 week as the dependent variable. Results:, A total of 1,186 patients were evaluated for eligibility, 814 were excluded, 129 refused, and 13 were missed, leaving 230 enrolled patients. The mean (±SD) age was 77 (±7.5) years, and 70% were female. In the first week, 92 of 230 patients (40%, 95% CI = 34% to 47%) had functional decline, 114 of 230 (49%, 95% CI = 43% to 56%) had new services initiated, and 76 of 230 had an unscheduled medical contact (33%, 95% CI = 27% to 39%). At 4 weeks, 77 of 219 had functional decline (35%, 95% CI = 29% to 42%), 141 of 219 had new services (65%, 95% CI = 58% to 71%), and 123 of 219 had an unscheduled medical contact (56%, 95% CI = 49% to 63%), including 15% with a repeated ED visit and 11% with a hospital admission. Family members provided the majority of new services at both time periods. Significant predictors of functional decline at 1 week were female sex (odds ratio [OR] = 2.2, 95% CI = 1.1 to 4.5), instrumental ADL dependence (IADL; OR = 2.5, 95% CI = 1.3 to 4.8), upper extremity fracture or dislocation (OR = 5.5, 95% CI = 2.5 to 11.8), lower extremity fracture or dislocation (OR = 4.6, 95% CI = 1.4 to 15.4), trunk injury (OR = 2.4, 95% CI = 1.1 to 5.3), and head injury (OR = 0.48, 95% CI = 0.23 to 1.0). Conclusions:, Older patients have a significant risk of short-term functional decline and other adverse outcomes after ED visits for injuries not requiring hospitalization for treatment. The most significant predictors of functional decline are upper and lower extremity fractures. [source]

    A Semiparametric Method for Analyzing Matched Case,Control Family Studies with a Continuous Outcome and Proband Sampling

    BIOMETRICS, Issue 3 2004
    Molin Wang
    Summary We consider matched case,control familial studies which match a group of patients, called "case probands," with a group of disease-free subjects, called "control probands," using a set of family-level matching variables. Family members of each proband are then recruited into the study. Of interest here is the familial aggregation of the response variable and the effects of subject-specific covariates on the response. We propose an estimating equation approach to jointly estimate the main effects and intrafamilial correlations for matched family studies with a continuous outcome. Only knowledge of the first two joint moments of the response variable is required. The induced estimators for the main effects and intrafamilial correlations are consistent and asymptotically normally distributed. We apply the proposed method to sleep apnea data. A simulation study demonstrates the usefulness of our approach. [source]

    2466: Blue cone nonochromacy gene mutation in Asia: phenotype variability

    Purpose A far East asian family with 4 affected maternal cousin males with congenital nystagmus, low vision and dyschromatopsia was investigated for a genetic cause after informed consent. Blue cone monochromacy is a rare form of X-linked visual handicap with dyschromatopsia. Methods Family members had ophthalmologic examination including visual acuity, fundoscopy , slit lamp, biomicroscopy,colour vision testing and ERG and VEP recordings.DNA analysis of the composition of the cone ospin gene cluster was performed by PCR and PCR/RFLP as well as direct sequencing of LWS opsin gene. Results A novel nonsense Mutation in the single Long wave sensitive opsin gene was identified in all affected males and carrier females. The variability of the phenotype as well as the added role of parental myopia transmission in the phenotype will be discussed. Conclusion This is the first reported molecular diagnosis of blue cone monochromacy in the Asian population. The compound effect of dominantly inherited myopia offers insight of the effect of the added mutational load in these patients. [source]

    Prospective effects of weight perception and weight comments on psychological health among Chinese adolescents

    ACTA PAEDIATRICA, Issue 12 2009
    Wing-Sze Lo
    Abstract Aim:, To investigate the prospective effects of weight perception of self and weight comments by others on psychological health problems among Chinese adolescents. Methods:, In the Hong Kong Student Obesity Surveillance project, 8716 adolescents (41.3% boys) aged 14.2 ± 1.7 years were followed prospectively. Logistic regression yielded odds ratios (ORs) for psychological health problems at 1-year follow-up by weight comments received and weight perception at baseline (2006), adjusting for each other sociodemographic factors and body mass index. Results:, Perceived fatness at baseline predicted subsequent headache and feeling stressful with adjusted ORs (95% confidence intervals) of 1.17 (1.03,1.33) and 1.20 (1.03,1.39), respectively. Perceived thinness at baseline did not predict any subsequent health problems. Receiving incorrect weight comments at baseline also predicted headache, feeling stressful and feeling depressed at follow-up, with adjusted ORs of 1.19 (1.08,1.31), 1.26 (1.04,1.53) and 1.38 (1.10,1.74) respectively. No gender difference was found in the effects of weight perception and weight comments on psychological outcomes. Conclusions:, In adolescents, perceived fatness and incorrect weight comments predicted psychological health problems at 1-year follow-up. Family members, peers and other social contacts should realize the potential adverse effects of their weight comments, and adolescents should be taught how to correctly assess their weight status. [source]

    Perceptions of constructive and destructive conflict within and across family subsystems

    Christina M. Rinaldi
    Family members' (mothers, fathers, siblings) perceptions of the frequency and types of constructive and destructive conflict strategies used within and across the three family subsystems (marital, parent,child, sibling) were investigated. Participants included 60 fifth- and sixth-grade, middle-class white children, their closest-in-age sibling, and both parents. Each family member rated their perceptions of conflict resolution strategies employed in marital, parent,child, and sibling relationships. Overall, family members demonstrated agreement on the frequency and types of conflict within the three family subsystems and generally reported employing similar conflict tactics across different subsystems. Additionally, parent,child conflict strategies were partially linked to both constructive and destructive sibling and marital conflict. These results are best understood in light of both the shared family perspective view and the spillover hypothesis of family dynamics (Margolin et al., 1996; Minuchin, 1988). Implications for examining conflict strategies within and across subsystems are discussed within the context of recent theory on family functioning. Copyright © 2003 John Wiley & Sons, Ltd. [source]