The psychological and social effects of myocardial infarction on wives.

Eighty-two wives of men suffering a first myocardial infarction were interviewed while their husbands were in hospital, and again two months and a year after they went home. The wives had substantial and persistent psychological symptoms, and the husbands'' illness had continuing effects on their work, leisure and social activities, and family life and marriage, their psychosocial disability being comparable to that of the patients. Measures of psychosocial adjustment before the illness and the quality of the marriage and of family life were good predictors of outcome for the wives. The women had a major role in the patients'' readjustment during convalescence, and their attitudes and behaviour as well as the general quality of family life were important determinants of the rate and extent of the patients'' recovery. The wives of patients with myocardial infarction should have more practical help and advice during the hospital period, and the whole family should be given advice and help throughout the convalescence.     

The ‘successful’ return: Caribbean narratives of migration,family, and gender

Research on female migrant caregivers has tended to focus upon the emotional and social problems they encounter working abroad, given women's traditional role as caregivers for their own families. This article analyses how Caribbean women who have returned after a period abroad as domestic workers inscribe their migration experiences within the gendered narrative of the good relative who migrates to help the family left behind and therefore deserves social recognition in the community of origin. It argues that this narrative allows the women to both affirm and reinterpret local family and gender roles within the context of migration. This analysis points to the close connection between narrative structures, accounts of migration experiences, and self‐presentations and suggests that narratives about family and gender roles not only reflect people's lives, but are also a malleable resource that can be (re)shaped to validate a variety of life‐courses.     

Psychiatry in General Practice

Psychiatrists should include the family doctor in their plans for future psychiatric services. The general practitioner now treats most of the patients who seek help for psychiatric disorder and he could not give up his psychiatric practice even if he wanted to. Furthermore, there are not now nor will there ever be enough psychiatrists to take over all patients with mental ills. Most emotionally disturbed patients can be better handled by their family physicians than by a specialist.To provide the best care for emotionally disturbed people the communication between family doctors and psychiatrists must be improved. The specialist must acknowledge the importance of the general practitioner''s role in psychiatric diagnosis and treatment and give him more help. Medical schools must provide better undergraduate and postgraduate psychiatric training for the students who will become family doctors. Health plans and other prepayment agencies should properly compensate the general practitioner for giving psychiatric treatment. The specialist in psychiatry should consult more readily with the general practitioner and help him carry out some of the therapy. General hospitals should permit family doctors to admit mental patients to psychiatric wards in a general hospital and to carry out psychiatric treatment with the help of the specialist in psychiatry.     

Making family planning accessible in resource-poor settings

It is imperative to make family planning more accessible in low resource settings. The poorest couples have the highest fertility, the lowest contraceptive use and the highest unmet need for contraception. It is also in the low resource settings where maternal and child mortality is the highest. Family planning can contribute to improvements in maternal and child health, especially in low resource settings where overall access to health services is limited. Four critical steps should be taken to increase access to family planning in resource-poor settings: (i) increase knowledge about the safety of family planning methods; (ii) ensure contraception is genuinely affordable to the poorest families; (iii) ensure supply of contraceptives by making family planning a permanent line item in healthcare system''s budgets and (iv) take immediate action to remove barriers hindering access to family planning methods. In Africa, there are more women with an unmet need for family planning than women currently using modern methods. Making family planning accessible in low resource settings will help decrease the existing inequities in achieving desired fertility at individual and country level. In addition, it could help slow population growth within a human rights framework. The United Nations Population Division projections for the year 2050 vary between a high of 10.6 and a low of 7.4 billion. Given that most of the growth is expected to come from today''s resource-poor settings, easy access to family planning could make a difference of billions in the world in 2050.     

"They're doing people a service"-qualitative study of smoking, smuggling, and social deprivation

ObjectivesTo examine the behaviour and attitudes related to smoking and contraband tobacco products among smokers in two socially deprived areas.DesignCross sectional study with qualitative semistructured interviews, augmented by smokers'' day grid.SettingTwo areas of socioeconomic deprivation in Edinburgh.Participants50 male and 50 female smokers aged 25-40 years randomly selected from general practitioners'' lists from two health centres, each located in an area of deprivation.ResultsMost smokers wanted to quit but felt unable to because of the importance of smoking in their daily routine and their addiction to nicotine. Strategies for maintaining consumption levels in the face of increasing cigarette prices and low income included purchasing contraband cigarettes and tobacco. Vendors were contacted through social networks, family, and friends as well as common knowledge of people and places, particularly pubs where contraband was available. Most users of contraband considered that smugglers were providing a valuable service. Purchasing contraband tobacco was viewed as rational in the face of material hardship. Many smokers criticised the government for its high tobacco taxation and the lack of local services to help them to stop smoking.ConclusionsSmokers in deprived areas perceive a lack of support to help them to stop smoking. Cigarette and tobacco smuggling is therefore viewed positively by low income smokers as a way of dealing with the increasing cost of cigarettes. Smokers in areas of deprivation may thus show little support for tackling smuggling until more action is taken to deal with the material and personal factors that make it difficult for them to quit.

What is already known on this topic

Areas of deprivation have the highest rates of smoking and lowest levels of cessationAround 25-30% of cigarettes consumed in the United Kingdom are contrabandWe know little about the attitudes of smokers in these areas to smuggled cigarettes or whether and how they access them

What this study adds

In such areas the easy availability of cheap tobacco products through contraband networks works against many smokers'' desire to quitGiven the perceived lack of support to help them to stop smoking, this smuggling network is viewed positively by low income smokers as a way of dealing with the increasing cost of cigarettesSmokers in areas of deprivation may thus show little support for tackling smuggling until more action is taken to address the material and personal factors that make it difficult for them to quit     

MDs must help eliminate 911 calls after "expected" home deaths,medical examiner advises

More and more Canadians are choosing to die at home. Unfortunately, family members may not know how to respond when death does occur. Some call 911 seeking advice, and soon find police, ambulance and fire services arriving at their door. If calls are made before terminal patients die, they may even be rushed to hospital for emergency care. The wasted energy wastes money and creates additional stress. Dr. John Butt, Nova Scotia''s chief medical examiner, says physicians must help educate the public and emergency services about how to respond after an expected death occurs at home.     

Reputation,a universal currency for human social interactions

Decision rules of reciprocity include ‘I help those who helped me’ (direct reciprocity) and ‘I help those who have helped others’ (indirect reciprocity), i.e. I help those who have a reputation to care for others. A person''s reputation is a score that members of a social group update whenever they see the person interacting or hear at best multiple gossip about the person''s social interactions. Reputation is the current standing the person has gained from previous investments or refusal of investments in helping others. Is he a good guy, can I trust him or should I better avoid him as a social partner? A good reputation pays off by attracting help from others, even from strangers or members from another group, if the recipient''s reputation is known. Any costly investment in others, i.e. direct help, donations to charity, investment in averting climate change, etc. increases a person''s reputation. I shall argue and illustrate with examples that a person''s known reputation functions like money that can be used whenever the person needs help. Whenever possible I will present tests of predictions of evolutionary theory, i.e. fitness maximizing strategies, mostly by economic experiments with humans.     

A new genus and species of Dipterocarpaceae from the Neotropics. II. Stem anatomy

An examination of the external morphology of a recent collection from Araracuara, Colombia, has suggested that the plant belongs to the primarily Old World family Dipterocarpaceae. A study of the wood, bark, and pith anatomy of this new taxon,Pseudomonotes tropenbosii Londoño, Alvarez & Forero, was undertaken to help confirm its systematic affinities. Comparisons ofPseudomonotes with data from the literature and reference wood slides, coupled with the use of computer-aided identification keys, support the view that its closest relationships probably are within the family Dipterocarpaceae. Detailed anatomical comparisons have revealed thatPseudomonotes' relationships are most likely to be with the subfamily Monotoideae, comprised of the African generaMonotes A. DC. andMarquesia Gilg.     

Number of siblings,family background,and the process of educational attainment

Abstract

Sociological research has found that educational attainment is the most important known determinant of men's occupational positions. Since the educational process occurs primarily while boys depend on their families, sociologists are increasingly interested in familial influences on education. This paper concentrates on the number of siblings in the family, and addresses two principal questions concerning the relation of sibship sire to educational outcomes. First, controlling for family background characteristics, does sibship size affect men's educational attainment and, if so, where in the educational process is this effect most evident? Second, among family variables, what is the relative importance of sibship size compared to the father's education, the father's socioeconomic status, farm background, and a broken family? Research was based on probability samples of 57,000 white men in the United States.     

Moderate drinking: an alternative treatment goal for early-stage problem drinking.

Family physicians are in a particularly good position to identify problem drinking in its early stages through the recognition of various psychosocial and medical indicators. Thorough history-taking or the use of a specific questionnaire should provide confirmation. Patients so identified can then be offered treatment designed to help them moderate their drinking, if not to achieve abstinence. The treatment strategy described in this paper involves specifying a safe drinking pattern, instructing the patient in the use of aids to appropriate drinking and seeing the patient at 1- to 2-month intervals for follow-up assessment. In a pilot study of this strategy 16 of 17 patients reduced their drinking substantially, and 8 were abstinent at the last follow-up visit. Only 1 of the 17 dropped out of treatment; the high rate of compliance may have been primarily due to the patient''s need to see the family physician for other problems. Visits to the family physician for other medical problems provide an opportunity to motivate patients to continue monitoring their drinking.     

Family caregivers' experiences of involuntary psychiatric hospital admissions of their relatives--a qualitative study

Background

Family caregivers of people with mental disorders are frequently involved in involuntary hospital admissions of their relatives.

Objective

To explore family caregivers'' experience of involuntary admission of their relative.

Method

30 in-depth interviews were conducted with family caregivers of 29 patients who had been involuntarily admitted to 12 hospitals across England. Interviews were analysed using thematic analysis.

Results

Four major themes of experiences were identified: relief and conflicting emotions in response to the relative''s admission; frustration with a delay in getting help; being given the burden of care by services; and difficulties with confidentiality.Relief was a predominant emotion as a response to the relative''s admission and it was accompanied by feelings of guilt and worry. Family caregivers frequently experienced difficulties in obtaining help from services prior to involuntary admission and some thought that services responded to crises rather than prevented them. Family caregivers experienced increased burden when services shifted the responsibility of caring for their mentally unwell relatives to them. Confidentiality was a delicate issue with family caregivers wanting more information and a say in decisions when they were responsible for aftercare, and being concerned about confidentiality of information they provided to services.

Conclusion

Compulsory admission of a close relative can be a complex and stressful experience for family caregivers. In order for caregivers to be effective partners in care, a balance needs to be struck between valuing their involvement in providing care for a patient and not overburdening them.     

Genetic Counseling—A Health Department Service to Physicians

Questions about inheritance in all kinds of diseases and defects are commonly asked of nearly all physicians. In attempting to answer these questions, however, the physician is often hampered by lack of formal instruction in clinical genetics.Since the health department, if it is to carry out its epidemiologic function, must be as concerned over the increasing identification of genetic agents in disease as it is and has been over environmental disease agents, it should come to represent a source of assistance not now generally available to the physician. In short, as it carries out those activities by which its store of general genetic information is increased, and until other sources of genetic consultation become reasonably available, the health department can be of real service to physicians as a resource to which they may turn for help when dealing with families wanting genetic information.Such a service has been provided experimentally for the last two years by the Contra Costa County Health Department.This program calls for the taking of family pedigrees by public health nurses on families with questions of a genetic nature who are health department clients and on families who are referred by their private physicians for this service. An interpretation of each pedigree is made by the department''s physician in charge of the program and submitted to the family''s physician for his use in counseling the family. Evidence to date suggests the process can be a highly useful service to the practitioner and his patient.     

Bereavement counselling after sudden infant death.

Of 14 families who suffered a sudden infant death, eight were followed up intensively over several months and offered individual counselling, parents'' group meetings, and interviews with doctors as a way of helping them come to terms with their feelings of loss. Five couples accepted short term support from their health visitor, and one refused help. Many families experienced considerable stress including marital conflict, difficulties with surviving children, and anxiety about future children becoming victims of the sudden infant death syndrome. It was concluded that medical social workers, health visitors, hospital paediatricians, general practitioners, and parent self help groups are in key positions to help. The success of such help is likely to depend on the confidence that each helper has that his or her contribution will be valued by the bereaved family.     

Modeling of a new tubercular maltosyl transferase,GlgE, study of its binding sites and virtual screening

Recently maltosyl transferase of Mycobacterium tuberculosis (mtb GlgE) belonging to α-amylase family has been identified as a potential drug target. Despite its importance, its three dimensional (3D) structure is unavailable. In this study we have modeled its 3D homo-dimeric structure using its homologue in Streptomyces ceolicolor (stp GlgE) as the template. Its monomer consists of five domains and four inserts, out of which two inserts are unique to mtb GlgE. It also has three binding cavities. One primary (pbs) and two secondary (sbs1 and sbs2), with one unique insert appearing within sbs2. Investigation of its homo-dimeric model revealed the presence of a disulphide bridge between Cys-29 of both the chains which is absent in stp GlgE. Virtual screening with known substrates and substrate analogues of α-amylase family proteins indicated better binding of maltose to sbs1 than pbs. Among all computationally screened substrates 3-O-Alpha-d-Glucopyranosyl-d-Fructose (OTU) docked with best binding affinity to pbs. Interaction of known inhibitors of α-amylase family proteins from CHEMBL is also studied. This reveals for the first time the unique 3D structure of mtb GlgE and provides insights into its active sites and substrate binding affinities. This may help in developing new anti-tubercular drugs and its analogues.     

Bridging Multiple Worlds: How African American and Latino Youth in Academic Outreach Programs Navigate Math Pathways to College

Universities have launched outreach programs to enhance their ethnic diversity, yet little developmental research examines students' pathways to college. This study compares capital models (highlighting family background) with challenge models (highlighting students' challenges and resources) in predicting pathways to college. The Bridging Multiple Worlds Model frames this longitudinal study of 120 African American and Latino youth in outreach programs. We examined students' family backgrounds; challenges and resources across family, school, peer, and community worlds; and high school math pathways as predictors of college eligibility and enrollment. African American students more typically had U. S. born, college-educated parents, and Latino students, immigrant parents with high school education or less. Second, students saw parents as greater resources than teachers, siblings, and themselves; peers and teachers were their greatest challenges. Youth distinguished resources and challenges more by their source than form. Third, high school math and English grades rose and fell together, with early math grades predicting college eligibility. Five math pathways emerged: steady, slowly declining, rapidly declining, increasing, and "back on track" toward college, but pathways did not always predict college choices. Fourth, although family background predicted few outcomes, parents' and teachers' help and siblings' challenges predicted grades, eligibility, and admission to prestigious colleges. Findings highlight both capital and challenge models for science, policy, and programs involving diversity and equity.     

Mothers,Fathers, Families,and Circumstances: Factors Affecting Children's Adjustment

The burgeoning empirical literature exploring the factors accounting for individual differences in psychological adjustment is reviewed. Many studies have shown that adjustment is largely affected by differences in the quality of parenting and parent–child relationships, the quality of the relationships between the parents, and the richness of the economic and social resources available to the family; more recent research signals the importance of congenital differences as well. Dimensions of family structure—including such factors as divorce, single parenthood, and the parents' sexual orientation—and biological relatedness between parents and children are of little or no predictive importance once the process variables are taken into account, because the same factors explain child adjustment regardless of family structure. These findings have important social and legal implications, especially in relation to decisions regarding foster care and adoption, as well as those concerning children's well-being following family dissolution.     

The Henrietta Lacks legacy grows

Now that the NIH has reached an agreement with Henrietta Lacks''s family concerning the use of the HeLa cell line, what lessons can we learn about informed consent and the unforeseen use of biological samples?On 7 August 2013, the US National Institutes of Health (NIH) announced that it had reached an agreement with the descendants of Henrietta Lacks concerning NIH-funded uses of the HeLa cell line [1], which, over the past 60 years has been featured in tens of thousands of experiments all over the world, and even in outer space.The origin of these cells, although never a secret, did not become well known until the 2010 publication of Rebecca Skloot''s book The Immortal Life of Henrietta Lacks. As was the practice of the time, Henrietta Lacks was not asked for permission to use samples of her tumour for research. For several decades, her family knew nothing about the HeLa cell line or its genetic tie to Henrietta Lacks—and to themselves. Henrietta Lacks''s contribution was little recognized and her family received no benefits from the widespread use of the cell line.On 11 March 2013, a team of researchers from The European Molecular Biology Laboratory (EMBL), led by Lars Steinmetz, published an article about the genomic characteristics of the one strain of the HeLa cell line [2]. Following current practice, they posted the whole genome sequence on-line, intending for it to serve as a resource to help other researchers; they did not intend or expect to set off an ethical controversy.But they did. Articles in the scientific press raised questions about publishing the genome sequence of the HeLa cell line [3], because although it had mutated enormously over the past 60 years, the data did provide some genomic information about Henrietta Lacks and, probabilistically, about her living descendants. As a result, Rebecca Skloot, on behalf of the Lacks family, raised concerns about their privacy.In the meantime, although the EMBL team had followed existing laws and regulations in its use of the HeLa samples, it responded to the controversy. The authors wrote to the Lacks family through Rebecca Skloot, apologizing for any distress the publication had caused, removed the sequence data from the internet, and offered to work with the family to find ways to make this potentially scientifically valuable information available while protecting the family''s interests and acknowledging Henrietta Lacks''s crucial role. At Steinmetz''s request, we conducted a bench-side ethics consult and provided some advice to the team as it strove to deal with this situation.The 7 August agreement between the NIH and the Lacks family resulted from discussions between Francis Collins and family members. It requires that any HeLa genomic information from NIH-associated studies be deposited in NIH''s ‘database of genotypes and phenotypes'' (dbGaP). A HeLa Genome Data Access Working Group made up of three scientists, two members of the Lacks family and one bioethicist will review requests to use the data, making recommendations to the Advisory Committee to the Director, and ultimately to the NIH Director. All publications that have used the data must include a specific acknowledgement of Henrietta Lacks and her family.This compromise is a reasonable resolution to an unusually extreme example of the increasing conflict between researchers'' need for broad availability of data (and samples) and legitimate privacy and autonomy interests of the people who are the sources of biological research materials and data. Unlike most research in recent decades, until this agreement, no one ever gave any permission for Henrietta Lacks'' tumour cells to be used for research. And the source of the HeLa cells is not only identifiable, but famous.However, the agreement is not completely enforceable. The Director of the NIH only has power over the NIH and the work it funds. We hope researchers not funded by NIH will abide by the agreement, both out of respect for the Lacks family and to help build trust among millions of other research subjects, but this cannot be guaranteed.A bigger issue is the many other human samples and data sets that are broadly accessible to researchers and sometimes the public. Some come with no consent, some have some consent, but few have actual and honest informed consent to be used for any purpose by any researchers or for data to be publicly available online. And although most are stripped of individual identifiers, that is cold comfort in an era of common breaches of data confidentiality and the use of other data sets to re-identify ‘anonymized'' data and samples [4].We cannot set up new administrative committees for every set of human data or biological samples. What we can do—and must do—is to make sure that, going forward, donors have knowingly made clear how they can, and cannot, be used. In addition, we must acknowledge that genomic information is no longer truly anonymous. These changes will require new understandings between researchers and research participants. The HeLa agreement provides a way to resolve that dilemma in an exceptional case; we now need to manage that conflict in common cases.One last note. Steinmetz and the EMBL group apologized to the Lacks family and took down the genomic data whilst a resolution could be explored. Jay Shendure and his group agreed to hold up publication of their similar paper [5] for the same end. The NIH seriously reached out to the family to make an agreement happen. And the Lacks family agreed. We think these acts—of consideration, patience and understanding, acknowledging and respecting the important role of research donors and participants—show an understanding of the underlying interests that researchers and research participants share. That all sides could find common ground in this most extraordinary case is perhaps the best result, and lesson, of the controversy.     

A Review on Torilis japonica: Ethnomedicinal,Phytochemical, and Biological Features

The present study was aimed at comprehensive overviewing a phytochemically and biologically important species namely Torilis japonica (Apiaceae family). Treatment of dysentery, fever, haemorrhoids, spasm, uterine tumors, lymphadenitis, rheumatism, impotence, infertility, women's diseases, and chronic diarrhea are reported as the main folk medicinal applications of the T. japonica fruits. So far, the plant is phytochemically characterized for its diverse terpene derivatives, predominantly sesquiterpenes. The plant's fruit is a rich source of torlin, a guaiane-type sesquiterpene, possessing various potent bioactivities. To date, anticancer, anti-inflammatory, antimicrobial, antioxidant, skin photoaging activities of the plant extracts and its constituents have been evaluated. Further investigation of the plant, specifically bioassay-guided isolation and identification of its major bioactive constituents can lead to discover potential phytopharmaceutical candidates.     

Like one of the family: race,ethnicity, and the paradox of US national identity

The tensions between individual rights promised to US citizens and group discrimination targeted against African Americans and similar racial/ethnic groups constitute one enduring paradox of US society. This essay examines this paradox by exploring how a gendered family rhetoric contributes to understandings of race and US national identity. Using African American women's experiences as a touchstone for analysis, the article suggests that African American women's treatment as second-class citizens reflects a belief that they are 'like one of the family', that is, legally part of the US nation-state, but simultaneously subordinated within it. To investigate these relationships, the article examines 1) how intersecting social hierarchies of race and ethnicity foster racialized understandings of US national identity; 2) how the gendered rhetoric of the American family ideal naturalizes and normalizes social hierarchies; and 3) how gendered family rhetoric fosters racialized constructions of US national identity as a large national family.