Marital status, marital satisfaction, and support processes among women at high risk for breast cancer.

This study explored marital status, social support processes, and psychological distress among women at high risk for breast and ovarian cancer who were anticipating genetic testing. In addition to substantive findings, it presents a means of using nonsense coding (J. Cohen & P. Cohen, 1983) to include unmarried persons in regression analyses examining the importance of marital support. These women had mobilized high levels of social support. Married and unmarried women did not differ in distress, but women had to have more satisfying marriages than average to be equivalent to unmarried women. For the married women, husbands were more involved and more influential in decision making than female relatives, even in distressed marriages. Negativity from close relationships, particularly the spouse, had more influence on these women's well-being than did positive involvement. The authors' findings suggest that counseling and education programs need to accommodate the key role that husbands have in decision making concerning genetic testing for risk of breast cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In vitro fertilization in women age 40 and older: the impact of assisted hatching

PURPOSE: To assess the impact of assisted hatching on in vitro fertilization (IVF) outcome in women age 40 and older. METHODS: A retrospective analysis was performed to compare 28 cycles of IVF without assisted hatching to 38 cycles of IVF with assisted hatching. All patients in both groups were age 40 or older and the mean age was similar. RESULTS: The delivery rate per oocyte retrieval was significantly higher in the assisted hatching group (18/38; 48%) compared to the nonhatched controls (3/28; 11%, P = 0.0003). The implantation rate of hatched embryos (40/175; 22%) was clearly enhanced, compared to the nonhatched embryos (7/126; 6%, P < 0.001). The fertilization rate, number of oocytes and the number of embryos per patient were comparable in the two groups. CONCLUSIONS: Assisted hatching dramatically improves embryonic implantation and term pregnancy rates in women age 40 and older undergoing IVF.     

Stress in employed women: impact of marital status and children at home on neurohormone output and home strain

We isolated peroxisome biogenesis mutants from Chinese hamster ovary (CHO) cells, using the 9-(1'-pyrene)nonanol/ultraviolet (P9OH/ UV) method and wild-type CHO-K1 cells that had been stably transfected with cDNA encoding Pex2p (formerly peroxisome assembly factor-1, PAF-1). Three mutant cell clones, ZP110, ZP111, and ZP114, showed cytosolic localization of catalase, thereby indicating a defect in peroxisome biogenesis, whereas ZP112 and ZP113 contained fewer but larger catalase-positive particles. Mutant ZP115 displayed an aberrant, tubular structure immunoreactive to anti-catalase antibody. Mutants lacking morphologically recognizable peroxisomes also showed the typical peroxisome assembly-defective phenotype such as severe loss of catalase latency and resistance to 12-(1'-pyrene)dodecanoic acid (P12)/UV treatment. ZP110 and ZP111, and ZP114 were found to belong to two novel complementation groups, respectively, by complementation group analysis with cDNA transfection and cell fusion. Cell fusion with fibroblasts from patients with peroxisome biogenesis disorders such as Zellweger syndrome revealed that ZP110 and ZP114 could not be classified to any of human complementation groups. Thus, ZP110/ZP111 and ZP114 are the first, two peroxisome-deficient cell mutants of newly identified complementation groups distinct from the ten mammalian groups previously characterized.     

Sequential interactions in the marital communication of depressed men and women.

Despite studies showing patterns of sequential interaction between depressed wives and their husbands, no published research has contrasted sequential interactions of depressed husbands and their wives. This study compared problem-solving interactions of 49 couples with a depressed husband, 41 with a depressed wife, and 50 normal controls. Interactions were coded using the Marital Interaction Coding System. Although no clear patterns of sequential interaction distinguished couples with a depressed wife from normal control couples, results suggested a unique pattern of interaction between depressed husbands and their spouses, whereby positive communications from the husband resulted in decreased positivity and increased negativity from their wives. Given the importance of positivity for promoting effective problem solving, this pattern appears to have important implications for couples' long-term marital satisfaction and husbands' mood regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of counselors' marital status, sex, and age on college and noncollege women's counselor preferences.

Examined women's preferences for counselors differing in marital status, sex, and age in 2 studies. Ss in Study 1 were 32 female undergraduates, and Ss in Study 2 were 32 noncollege women. The experimental design for both studies was a 2.24 split-plot analysis of variance with 2 levels of marital status, 2 levels of counselor sex, and 4 age groupings. Results of Studies 1 and 2 indicate that college women and noncollege women preferred female counselors older than themselves to male counselors on a number of hypothetical process measures. Changing trends in women's counselor preferences are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of methadone on consumption of inpatient care and mortality, with special reference to HIV status

This study investigates the impact of methadone treatment on inpatient care admissions and mortality among 331 methadone-maintained patients compared with 1,483 similar untreated opiate misusers. The methadone patients manifested a lower mortality during treatment than the comparison group and those patients who had left their treatment. The annual incidence rate decreased from 1.4 inpatient care admissions per year for those who had stayed 0-1 year, less than 1 for those who stayed more than 2 years, and 0.3 for those who had stayed longer (>4 years) in methadone treatment. A similar decrease occurred in both sexes. The incidence rate decreased more among the HIV-negative than the HIV-positive patients. The low incidence of inpatient care during treatment may be due to treatment but may also be partly due to selection factors.     

Effects of education and support on breast self-examination in older women

The purpose of this study was to determine the effects of an educational program and structured support on breast self-examination (BSE) frequency, proficiency, and perceived control in middle-aged and older women at 6 and 12 months after instruction. Women were randomly assigned to one of three treatment groups: (a) no-support control group; (b) peer support group; and (c) selected partner support group. All women received the same instructional program. Women assigned to peer and selected partner support groups received additional reinforcement from their partners to perform BSE for the next 6 months. There were significant differences between the initial interview and 6-month scores on BSE frequency, expert and self-rating of proficiency, and perceived skill. Self and expert ratings of proficiency and perceived skill continued to increase at 12 months postinstruction. No significant differences were found among the three support treatment groups.     

The impact of sex therapy on sexual behaviors and marital communication

The evaluation results of a short term intensive sex dysfunction workshop are presented. The evaluation research design involves before and after measures of sexual behaviors, sexual expectations, sexual communication, and marital communication. The results indicate that participants changed with regard to each of these variables. The workshop appears to impact couples in three ways: (1) there is a narrowing of the gap between actual and desired sexual behaviors, (2) there is improved sexual communication, and (3) there is improved marital communication. The results indicate that a combination of group instruction and individual therapy is an effective intervention technique in treating couples with sexual problems.     

The use of mammography by women aged 75 and older: factors related to health, functioning, and age

BACKGROUND AND OBJECTIVES: Mammographic screening for breast cancer is of uncertain clinical benefit for women 75 years of age and older. Some have argued against instituting routine screening in this age group, noting that disability and shorter life expectancy may diminish the desirability and cost-effectiveness of screening. We sought to determine the extent to which health, functioning, and age influence mammography use in this cohort. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study of a representative sample of women in the US aged 75 and older (n = 2352) who participated in the Medicare Current Beneficiary Survey. MEASURES: Information about general health, level of functioning, medical history, age, and various sociodemographic characteristics elicited in the survey was linked with subjects' Medicare bills for 1991 and 1992 to ascertain patterns of mammography use. RESULTS: Overall, 26.7% of the women had mammograms during the 2-year period. Advanced age was associated with a decreased likelihood of receiving a mammogram. This did not reflect simply the decline in health and functioning that may accompany aging; those aged 85 and older were less likely to receive mammograms than those in the 75 to 79 age group, controlling for general health, medical history, functional status, and sociodemographic factors (adjusted OR = .41; 95% CI = 0.27 to 0.64). ADL limitations were also associated independently with decreased mammography use. For example, controlling for age, women with any limitations in Activities of Daily Living were 0.71 times as likely to have mammograms as women without ADL limitations (95% CI = 0.59 to 0.85). However, several comorbid conditions, including hypertension, diabetes mellitus, and a history of myocardial infarction were not significantly related to mammography use. CONCLUSIONS: Within the cohort of women aged 75 and older, more advanced age and impaired functional status both substantially reduce the likelihood of mammography use. The extent to which this reflects patients' informed decisions, physicians' judgments, or other factors remains to be explored.     

Relationship of neurological function and age in older women. The study of osteoporotic fractures

The decline of neurological and neuromuscular function with age in older women and in subgroups of older women with selected risk factors for poor function is described using cross- sectional analyses of data on 8,080 women from the multicenter Study of Osteoporotic Fractures. All twelve performance-based tests of muscle strength, balance, gait, somatosensory discrimination and reaction time declined with increasing age. On a percentage scale, vibration threshold declined the most rapidly with age. Participants who were smokers, physically inactive, nonconsumers of alcohol, diabetics and more frequent fallers had poorer age-adjusted performance than those without these attributes. However, with a few exceptions, the rate of decline in performance with age for those with and without these characteristics did not differ significantly.     

Learn, share, and live: breast cancer education for older, urban minority women

Among older urban minority women, for whom breast cancer risk is high and the propensity to be screened is low, both social support and breast cancer knowledge have been linked to mammography use. The authors describe a theory-based breast cancer education program implemented via an existing informal network for low-income urban elderly coordinated by a social service agency. The program is both structured and flexible. Core education sessions include delineated content and methods and are led by health professionals. Participants choose from a variety of follow-up activities to promote screening within their community. Pre- and posttests administered among 80 program attendees in two sites indicate significant improvement in knowledge (p < .001). Program attendees in each site also planned and participated in follow-up activities to promote screening among their peers. Learn, Share, and Live seems to be an effective program for promoting breast cancer screening among older, urban, primarily minority women.     

Positive and negative characteristics of marital interaction and their association with marital satisfaction in middle-aged and older couples.

The study examined age differences in positive (e.g., warm) and negative (e.g., hostile) characteristics of marital interactions between middle-aged and older couples and whether these characteristics were differentially associated with marital satisfaction by age. Spouses' perception of partners' positive and negative behavior during marital interaction was assessed in general and following disagreement and collaborative tasks. Trained observers coded spouses' positive and negative behavior during interactions. Older individuals reported higher marital satisfaction and perceived their spouse's behavior as less negative in general and more positive across all contexts than middle-aged individuals. Spouses' perceptions of their partners' positive and negative behavior independently predicted marital satisfaction for both age groups across contexts. Perceptions of partners' negative behavior in general and of both positive and negative behavior in the disagreement task were more closely associated with marital satisfaction for older spouses than for middle-aged spouses. Results point to the importance of positive and negative characteristics in marital functioning across age cohorts and indicate that such characteristics may be context dependent. Findings suggest that, in some contexts, both positive and negative characteristics are more salient for older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Formal home care services: examining the long-term care needs of rural older women

Trauma is the leading cause of death in people less than 40 years old (Central Statistics Office, 1994). Patients who have sustained major trauma will often have multiple injuries. The key to treating these patients is an organized and systematic method of examination and treatment to ensure that injuries are not missed and left untreated.     

Effect of age and menopausal status on cardiorespiratory fitness in masters women runners

Forty-nine trained masters women endurance runners (mean = 42 km.wk-1) between the ages of 35 and 70 yr (mean = 46.4 +/- 8.3) were tested on a treadmill to examine cardiorespiratory fitness (VO2max and VO2 submax) in relation to age, training, and menopausal status. Although VO2max was lower with increasing age, no age group differences occurred in VO2 submax at 5.4 km.h-1, 8% treadmill grade. The younger runners (35-39 and 40-44 yr) had significantly higher VO2max than the other 5-yr competitive age groups (45-49, 50-55, 55-70 yr) (P < 0.01). HR max did not differ across age, but HR submax was higher with increasing age. Premenopausal, transitional, and post-menopausal women were not significantly different on any exercise variable when age and/or training differences among the groups were statistically controlled. A decrease in VO2max of 0.58 ml.kg-1 x min-1 x yr-1 was determined (r = -0.62). It was concluded that 1) these highly trained women runners had higher cardiorespiratory fitness than previously reported for women of comparable age, 2) menopausal status did not effect cardiorespiratory fitness when age and training were accounted for, and 3) regular physical training seems to prevent age-related changes in HR max in women, but not age-related changes in maximal oxygen uptake.     

Sequential analysis of marital interactions involving alcoholic, depressed, and nondistressed men

This study was based on the investigators' earlier work on alcoholism and the family and involved a comprehensive assessment of sequential patterns associated with the marital interactions of alcoholic, depressed, and nondistressed men. A total of 131 couples were assessed in a laboratory-based discussion of personally relevant problems. Videotaped observations were conducted during drinking and nondrinking sessions and were subsequently coded according to the Marital Interaction Coding System. Depressed couples were most distinguishable in terms of unique antecedent-consequent patterns, whereas alcoholic and nondistressed control couples were similar to one another and different from depressed couples. Results are discussed in regard to the extant literature on interpersonal theories of depression and alcoholism and in regard to future research needs.     

Survival of women with breast cancer in Europe: variation with age, year of diagnosis and country. The EUROCARE Working Group

Breast cancer is the most frequent malignancy among women in developed countries. Prognosis is better than for other major cancers, and an improvement in survival has been reported for several populations in recent decades. Within the framework of EUROCARE, a population-based project concerned with the survival and care of cancer patients in Europe, we analysed data from 119,139 women diagnosed with breast cancer between 1978 and 1985 in 12 countries and followed for at least 6 years. Multiple regression models of relative survival, which take mortality from all other causes in each area into account, were used to estimate the effect of age, period of diagnosis and country on survival. For the comparison between countries, survival rates were age-standardised to the age structure of the entire study population. Women aged 40-49 years at diagnosis had the best prognosis in all countries and throughout the study period. Women younger than 30 years at diagnosis had a worse prognosis than those aged 30-39. The highest relative survival at 5 years was in Finland and Switzerland (about 74%), intermediate levels were found for Italy, France, The Netherlands, Denmark and Germany (about 70%) and the lowest rates were in Spain, the United Kingdom, Estonia and Poland (55-64%). During the 6 months following diagnosis, survival was highly dependent on age and was sharply lower in women older than 49 years. For women surviving more than 6 months after diagnosis, survival was similar for all ages, although women aged 40-49 still had the better prognosis. The average rate of death from breast cancer fell by about 2.5% for each year of diagnosis between 1978 and 1985. This improvement manifested mainly in younger and older women, for whom survival was initially less good. The largest improvement was seen in Poland (-15% death risk per year). We suggest that the better survival of women aged 40-49 at diagnosis is related to lower levels of circulating sex hormones, resulting in reduced stimulation of tumour cell growth. Early diagnosis may also be important in the peri-menopausal period due to increased diagnostic attention. Low survival in the United Kingdom may be due to inadequate adherence to consensus treatment guidelines and greater variation in treatment.     

The effects of alcohol on the marital interactions of aggressive and nonaggressive husbands and their wives.

This study examined the marital interactions of 60 maritally aggressive and 75 nonaggressive men and their wives under a baseline condition, and then after the husband had received no alcohol, a placebo, or alcohol. These sessions were videotaped and coded with the Marital Interaction Coding System by coders who were unaware of group status and specific condition. Aggressive couples exhibited more negative behavior and higher levels of negative reciprocity in the baseline interaction than did nonaggressive couples. The administration of alcohol led husbands, but not wives, to increase their problem-solving attempts. Alcohol, but not the placebo, led to increased negativity of both husbands and wives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The longitudinal impact of demand and withdrawal during marital conflict.

Forty-eight couples completed a measure of relationship satisfaction and participated in 2 videotaped problem-solving interactions, 1 focused on an issue identified by the woman and 1 focused on an issue identified by the man. Thirty-six men and 36 women completed the satisfaction measure again 2.5 years later. Demandingness, and to a lesser extent withdrawal, during the interactions showed many significant associations with both Time 1 and Time 2 satisfaction. The relationship of demandingness and withdrawal to change in satisfaction was also examined using both change scores and partial correlations. Withdrawal by men and woman demand-man withdraw during discussions of issues identified by the women reliably predicted change (decline) in wives' relationship satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)