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Family Unit (family + unit)
Selected AbstractsTotal Family Unit Helicobacter pylori Eradication and Pediatric Re-Infection RatesHELICOBACTER, Issue 4 2004Stephen Farrell ABSTRACT Background., Re-infection with Helicobacter pylori is more common in children than adults, and it is generally accepted that the family unit plays a significant role in primary childhood infection. We investigated whether the family unit plays a significant role in pediatric re-infection and if eradication of H. pylori from the entire family reduces the risk of childhood re-infection. Methods., Fifty families, each with an H. pylori -infected pediatric index case (mean age 9.48 years), were recruited. A 13carbon urea breath test was performed on all family members in the same house as the index case. Each family unit was randomized into a ,family unit treatment' group (all infected family members treated) or an ,index case treatment' group (index case only treated). Results., At long-term follow-up (mean 62.2 months), there were three re-infected children in the ,index case treatment' group compared with one in the ,family unit treatment' group. The re-infection rate was 2.4% per patient per year in the ,index case treatment' group and 0.7% per patient per year in the ,family unit treatment' group (p = .31). Conclusions., This study is the first to evaluate the effect of total family unit H. pylori eradication on pediatric re-infection rates and reports the longest period of re-infection follow-up in children. In childhood, re-infection with H. pylori is not significantly reduced by family unit H. pylori eradication. [source] A phenomenological exploration of the lived experience of mental health nurses who care for clients with enduring mental health problems who are parentsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 8 2010S. MADDOCKS mnurssci rn Accessible summary ,,Among people with mental health problems, those who are parents may not have their needs met, especially when receiving inpatient care. ,,There is little research regarding the needs of this group. ,,An integrated model of care is required. Abstract This paper is a report of a study to explore mental health nurses' lived experience of caring for adults with enduring mental health problems who are parents. With the advent of community care, more people with enduring mental health problems have contact with their families and are parents. Ultimately, rehabilitative strategies for parents with mental health problems are focused towards functioning effectively within their own family unit and hopefully enabling them to fulfil their parental role. Mental health nurses working with this client group have competing demands to reconcile. For example, advocating for client rights versus protecting the child and supporting the family. This phenomenological study took place within adult mental health services in the UK. Semi-structured interviews were conducted with six nurses. A thematic analysis was conducted on the data. Five themes were identified from the data: support, remaining impartial, addressing the specific needs of a client who is a parent, models of care and interagency communication. The findings suggest that neither a family-centred nor a person-centred approach to care completely meets the needs of this client group. An integrated model of care is proposed that applies person-centred and family-centred approaches in tandem. [source] Low-Income Latina Mothers' Expectations for Their Pregnant Daughters' Autonomy and InterdependenceJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 2 2008Erum Nadeem Forty-five pregnant Latina adolescents and their mothers (23 English-speaking, 22 Spanish-speaking) were videotaped conversing about feelings and plans related to the adolescent's pregnancy. The prevalence of the mothers' messages about the daughter's reliance on the family unit (interdependence) and the daughter's self-sufficiency (autonomy) were related to adolescents' reported and observed feelings about their pregnancies, pending motherhood challenges, and their relationships with their mothers. Increased interdependence messages appeared to denote positive family relations among Spanish-speaking dyads, in that these adolescents reported more positive feelings about their pregnancy, perceived that their mothers felt more positive, and perceived more maternal social support and open communication. The role of interdependence messages was less clear for adolescents from English-speaking families. Higher levels of maternal autonomy messages had positive associations for both groups, in that it was related to higher disclosure about concerns about childcare needs among adolescents from English-speaking families, and about educational goals for adolescents from Spanish-speaking families. [source] Twenty years of follow-up among survivors of childhood and young adult acute myeloid leukemia,CANCER, Issue 9 2008A report from the Childhood Cancer Survivor Study Abstract BACKGROUND Limited data exist on the comprehensive assessment of late medical and social effects experienced by survivors of childhood and young adult acute myeloid leukemia (AML). METHODS This analysis included 272 5-year AML survivors who participated in the Childhood Cancer Survivor Study (CCSS). All patients were diagnosed at age ,21 years between the years 1970 and 1986, and none underwent stem cell transplantation. Rates of survival, relapse, and late outcomes were analyzed. RESULTS The average follow-up was 20.5 years (range, 5,33 years). The overall survival rate was 97% at 10 years (95% confidence interval [95%CI], 94%,98%) and 94% at 20 years (95% CI, 90%,96%). Six survivors reported 8 recurrences. The cumulative incidence of recurrent AML was 6.6% at 10 years (95% CI, 3.7%,9.6%) and 8.6% at 20 years (95% CI, 5.1%,12.1%). Ten subsequent malignant neoplasms (SMN) were reported, including 4 with a history of radiation therapy, for a 20-year cumulative incidence of 1.7% (95% CI, 0.02%,3.4%). Six cardiac events were reported, for a 20-year cumulative incidence 4.7% (95% CI, 2.1%,7.3%). Half of the survivors reported a chronic medical condition and, compared with siblings, were at increased risk for severe or life-threatening chronic medical conditions (16% vs 5.8%; P < .001). Among those aged ,25 years, the age-adjusted marriage rates were similar among survivors and the general United States population (57% for both) and lower compared with siblings (67%; P < .01). Survivors' college graduation rates were lower compared with siblings but higher than the general population (40% vs 52% vs 34%, respectively; P < .01). Employment rates were similar between survivors, siblings, and the general population (93%, 97.6%, and 95.8%, respectively). CONCLUSIONS Long-term survival from childhood AML ,5-years after diagnosis was favorable. Late-occurring medical events remained a concern with socioeconomic achievement lower than expected within the individual family unit, although it was not different from the general United States population. Cancer 2008. © 2008 American Cancer Society. [source] Physically active families , de-bunking the myth?CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2010A qualitative study of family participation in physical activity Abstract Background The benefits of physical activity for reducing obesity and related chronic diseases are well known. The need for more family-based interventions to increase physical activity is frequently cited in the literature; however, little is known about if and how families are physically active together, and what factors might influence family-based participation in regular physical activity. This study examined the types of activities (physical and sedentary) engaged in as a family and explored parents' perceptions of the importance, frequency, nature and barriers to family physical activity. Methods Semi-structured telephone interviews were conducted with 30 parents (26 female, four male) of 10- to 11-year-old schoolchildren who attended either low, middle or high socio-economic status schools in Bristol, UK. Interviews were transcribed verbatim, anonymized and analysed using conventional content analysis. Results The majority of parents rated family engagement in physical activity as important, and identified benefits such as increased parent,child communication, spending time together, enjoyment, enhanced mental health, weight control and physical fitness. Despite these benefits most parents reported their families did little or no physical activity together as a family unit during the week, and any activities performed together were usually sedentary in nature. They reported increased family physical activity on the weekends but rarely including the full family unit simultaneously. Parents in two-parent households commonly paired off with one or more children because of complexities of schedules. Commonly reported barriers were busy lifestyles, diverse ages and interests of children and adults, bad weather, and lack of access to facilities, transportation and money to support activities. Conclusions Family-based interventions might be more effective if they are designed to accommodate the complex demands and needs of two-parent and single-parent families and provide affordable, diverse activities appealing to a wide range of interests. [source] Child or family assessed measures of activity performance and participation for children with cerebral palsy: a structured reviewCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2005C. Morris Abstract Background, There is a need to measure children's ,activity performance and participation' as defined in the World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth (WHO ICF). The aim of this review is to identify instruments that are suitable for use in postal surveys with families of children with cerebral palsy. Methods, We conducted a structured review of instruments that use child or family self-assessment of ,activity performance and participation'. The review involved a systematic search for instruments using multiple published sources. Appraisal of the instruments used the predefined criteria of appropriateness, validity, reliability, responsiveness, precision, interpretability, acceptability and feasibility. Results, There are relatively few child or family assessed instruments appropriate for measuring children's activities and participation. Seven instruments were identified that could potentially be administered by mail. The Assessment of Life Habits for Children (LIFE-H) was the most appropriate instrument as assessed by its content but the reliability of child or family self-assessment is not known. If the LIFE-H were shown to be a reliable self-report measure then the LIFE-H would be the recommended choice. Currently, the Activities Scale for Kids and the condition-specific Lifestyle Assessment Questionnaire for cerebral palsy (LAQ-CP) provide the broadest description of what and how frequently children with cerebral palsy perform a range of activities and thereby indicate participation. The LAQ-CP also provides additional contextual information on the impact of any disability on the participation of the family unit. Conclusion, There remains much scope for developing valid and reliable self-assessed measures corresponding to the WHO ICF dimensions of activities and participation. [source] Family functioning and juvenile chronic physical illness in Northern RussiaACTA PAEDIATRICA, Issue 2 2009A Zashikhina Abstract Aim: To study family functioning of adolescents with chronic physical illnesses and factors related to it. The following research questions were addressed: (i) if families with adolescents with chronic physical illnesses were at increased risk for problematic functioning compared to the healthy control families; (ii) was disease severity associated with family dysfunction; and (iii) did family functioning level differ in three disease groups (diabetes, asthma and epilepsy). Methods: Self-report family inventory and socio-economic status questions were individually completed by 148 adolescents with physical illnesses aged 13,16 years and their mothers; medical data were obtained from the files at the outpatient clinics. Comparative data were collected from a group of 301 schoolchildren. Results: Overall there were no differences found in functioning of families with physically ill adolescents compared to controls. Family functioning was significantly associated with the number of disease-specific (disease severity and duration) and non-disease (socio-economic status and family type) factors. Conclusion: In our study, families with physically ill adolescents showed considerable resilience and tolerance to the changes in habitual functioning of the family unit. While greater disease severity, longer disease duration, as well as single-parent household were the factors that contributed to the family dysfunction. [source] Migration and Transnational Families in Fiji: Comparing Two Ethnic GroupsINTERNATIONAL MIGRATION, Issue 4 2008Carmen Voigt-Graf In the past two decades, international migration patterns out of Fiji have undergone changes with important implications for the formation of transnational families. The focus of this paper is on a comparison between the formation of Indo-Fijian transnational extended families and indigenous Fijian transnational nuclear families. These are discussed within the framework of "transnational corporations of kin." For several decades, Indo-Fijians have permanently migrated to the Pacific Rim as a consequence of the economic and political situation in Fiji. They have resettled in complete nuclear family units and have subsequently attempted to sponsor the migration of their extended family members. Recent years have witnessed an increasing number of indigenous Fijians migrating temporarily for work. In contrast to Indo-Fijians, indigenous Fijian migrate as individuals, leaving their spouses and children behind in Fiji. Women migrate autonomously as caregivers and nurses while men find employment as soldiers and security officers. The main purpose of their mostly temporary migration is to send remittances. However, these economic benefits have to be contrasted with the social and psychological costs associated with the separation of nuclear families. The paper also discusses policy implications arising from the comparative analysis, especially in the light of the current situation in Fiji which is characterised by a lack of policies addressing the implications of migration. Migration et familles transnationales à Fidji: comparaison de deux groupes ethniques Durant ces vingt dernières années, les tendances migratoires internationales au départ de Fidji ont subi des changements qui ont eu d'importantes conséquences sur la constitution de familles transnationales. Le thème central de cette publication porte sur une comparaison entre la constitution de familles transnationales indo-fidjiennes élargies et les familles transnationales fidjiennes indigènes nucléaires. Celles-ci sont examinées dans le cadre de ce que l'on appelle les sociétés familiales transnationales. Depuis plusieurs dizaines d'années, les Indo-Fidjiens migrent à demeure vers la ceinture du Pacifique en raison de la situation économique et politique de Fidji. A partir de là, ils reprennent le schéma de la famille nucléaire complète et tentent ensuite de financer la migration des membres de leur famille élargie. Les dernières années ont mis en évidence une tendance croissante des Fidjiens indigènes àémigrer temporairement en quête de travail. A la différence des Indo-Fidjiens, les Fidjiens indigènes émigrent seuls, en laissant derrière eux femmes et enfants. Les femmes émigrent de façon autonome en quête d'un emploi d'aidante ou d'infirmière tandis que les hommes se font embaucher comme soldats ou agents de sécurité. L'objectif principal de leur migration le plus souvent temporaire est de rapatrier des fonds. Cependant, ces avantages économiques doivent être rapportés aux conséquences sociales et psychologiques découlant de la séparation des familles nucléaires. L'article examine également les répercussions politiques résultant de l'analyse comparative, surtout à la lumière de la situation actuelle à Fidji, laquelle dénote l'absence de politiques appropriées pour faire face aux conséquences de la migration. La migración y las familias transnacionales en Fiji: Comparación de dos grupos étnicos En los últimos veinte años, los patrones de migración internacional desde Fiji han sufrido cambios que han repercutido notablemente en la conformación de familias transnacionales. En este artículo, se establece una comparación entre la conformación de familias indo-fiyianas transnacionales amplias y las familias indígenas fiyianas transnacionales nucleares. Ambas se debaten en el marco de "corporaciones transnacionales de parentesco". Durante varias décadas, los indo-fiyianos emigraron con carácter permanente a la costa del Pacífico a raíz de la situación económica y política prevaleciente en Fiji. Se reasentaron en unidades familiares nucleares completas y, ulteriormente, intentaron patrocinar la migración de sus familiares. En los últimos años, se ha observado un creciente número de fiyianos indígenas que emigran temporalmente por motivos laborales. A diferencia de los indo-fiyianos, los fiyianos indígenas emigran a título individual, dejando atrás a cónyuges e hijos. Las mujeres emigran de manera autónoma para trabajar al cuidado de personas o como enfermeras, mientras que los hombres encuentran trabajo como soldados o guardias. Su migración es mayormente de carácter temporal y tiene por finalidad el envío de remesas. Ahora bien, estos beneficios económicos tienen que examinarse a la luz de los costos sociales y sicológicos asociados con la separación del núcleo familiar. En este artículo también se debaten las consecuencias políticas resultantes del análisis comparativo, especialmente habida cuenta de la situación reinante en Fiji, que se caracteriza por la falta de políticas que encaren las repercusiones que trae consigo la migración. [source] A brief review of the status, distribution and biology of wild Asian elephants Elephas maximusINTERNATIONAL ZOO YEARBOOK, Issue 1 2006R. SUKUMAR The Asian elephant Elephas maximus is distributed discontinuously across the Asian continent. The total wild population is 38 500-52 500, with a further c. 16 000 in captivity, the majority of which are in range countries. India has 60% of the global population of wild Asian elephants. The species has a multi-tiered social system with ,, living in matriarchal groups of five to 20 individuals that interact with other family units in the area. Adult ,, live alone or in small, temporary groups with weak social bonds. Asian elephants are megaherbivores that spend 12-18 hours per day feeding, and they eat browse and plants depending on availability and season. Home-range size is dependant on the availability of food, water and shelter in the region. Loss and fragmentation of habitat, human-elephant conflicts and poaching are the greatest threats to the species. Asian elephants are managed using traditional and modern methods but progress still needs to be made to improve welfare, training and breeding for these animals. [source] Early age reproduction in female savanna elephants (Loxodonta africana) after severe poachingAFRICAN JOURNAL OF ECOLOGY, Issue 2 2009M. J. Owens Abstract A 10-year study revealed that after severe poaching (>93% killed) of elephants (Loxodonta africana) in Zambia's North Luangwa National Park (NLNP) during the 1970s and 1980s, the age of reproduction in females was greatly reduced. Fifty-eight per cent of births were delivered by females aged 8.5,14 years, an age at which elephants were reported to be sexually immature in nearby South Luangwa National Park (SLNP) before poaching. The mean age of females at first birth (AFB) (1993, 1994) was 11.3 years. Prior to poaching, the mean age AFB in SLNP was 16 years. The NLNP age structure and sex ratio were skewed, mean family unit size was reduced, and 37% of family units contained no females older than 15 years. Twenty-eight per cent of family units were comprised entirely of a single mother and her calf, and 8% of units consisted only of orphans who would have been considered sexually immature prior to poaching. Only 6% of survivors were older than 20 years, the age at which females in little-poached populations generally become most reproductively active. After a community-based conservation programme and the UN-CITES ban on the ivory trade were introduced, no elephants were recorded killed. In spite of a high reproductive rate, 6 years after poaching decreased, the density of the NLNP population had not increased, supporting predictions that the removal of older matriarchs from family units will have serious consequences on the recovery of this species. Résumé Une étude qui a duré dix ans a révélé qu'après un braconnage très grave (>93% tués) des éléphants (Loxodonta africana) dans le Parc National de Luangwa Nord (NLNP), en Zambie au cours des années 1970 et 1980, l'âge de la reproduction chez les femelles a fort baissé. Cinquante-huit pour cent des naissances se sont passées chez des femelles qui avaient entre 8,5 et 14 ans, un âge auquel les éléphants étaient dits être encore sexuellement immatures dans le Parc National de Luangwa Sud (SLNP), tout proche, avant le braconnage. L'âge moyen des femelles à la première mise-bas (AFB ,at first birth) (1993, 1994) était de 11,3 ans. Avant le braconnage, l'âge moyen à la première mise-bas était de 16 ans au SLNP. Au NLNP, la structure d'âge et le sex-ratio ont été faussés, la taille moyenne de l'unité familiale a été réduite, et 37% des familles ne contiennent aucune femelle de plus de 15 ans. Vingt-huit pour cent des unités familiales n'étaient composées que d'une mère seule et de son jeune, et huit pour cent n'étaient composées que d'orphelins qui devaient être considérés comme sexuellement immatures avant le braconnage. Seuls six pour cent des survivants avaient plus de 20 ans, l'âge auquel les femelles de populations peu braconnées deviennent généralement les plus actives en matière de reproduction. Après l'introduction d'un programme de conservation communautaire et l'interdiction, par la CITES-UN, du commerce de l'ivoire, on n'a plus enregistré aucun massacre d'éléphant. Malgré un taux élevé de reproduction, la densité de population du NLNP n'a pas augmenté, ce qui conforte les prédictions que l'enlèvement des plus vieilles matriarches des unités familiales aura de sérieuses conséquences sur la restauration de cette espèce. [source] Statistical Inference for Familial Disease ClustersBIOMETRICS, Issue 3 2002Chang Yu Summary. In many epidemiologic studies, the first indication of an environmental or genetic contribution to the disease is the way in which the diseased cases cluster within the same family units. The concept of clustering is contrasted with incidence. We assume that all individuals are exchangeable except for their disease status. This assumption is used to provide an exact test of the initial hypothesis of no familial link with the disease, conditional on the number of diseased cases and the distribution of the sizes of the various family units. New parametric generalizations of binomial sampling models are described to provide measures of the effect size of the disease clustering. We consider models and an example that takes covariates into account. Ascertainment bias is described and the appropriate sampling distribution is demonstrated. Four numerical examples with real data illustrate these methods. [source] Family Networks of Obesity and Type 2 Diabetes in Rural AppalachiaCLINICAL AND TRANSLATIONAL SCIENCE, Issue 6 2009Petr Pancoska Ph.D. Abstract The prevalence of obesity and diabetes has been studied in adolescent and adult populations in poor, medically underserved rural Appalachia of West Virginia. A web-based questionnaire about obesity and diabetes was obtained in 989 family members of 210 Community Based Clinical Research (CBPR) trained adolescent members of a network of 18 science clubs, incorporating 142 families. After age-correction in < 20 years old, 50% of both adolescents and adults were obese. The frequency distribution of obesity was trimodal. In the overall population 10.4% had type 2 diabetes, while 24% of adult, obese subjects had type 2 diabetes. A new metric, the family diabetes risk potential, identified a trimodal distribution of risk potential. In the lowest most common distribution 43% of families had a diabetic family member. In the intermediate distribution, 69% had a diabetic family member, and in the distribution with highest scores all the families had a diabetic member. In conclusion, the poorest counties of rural Appalachia are at crisis level with the prevalence of obesity and diabetes. The distribution of age-corrected obesity and family diabetes risk potential are not normally distributed. We suggest that targeting individual family units at greatest risk offers the most efficient strategy for ameliorating this epidemic. [source] | ||||||||||||||||