Profile of durable and successful marriages: A new competency-based marital education program / Perfil de los matrimonios largos y exitosos: un nuevo programa de educación marital basado en competencias

Abstract The aim of this study was to assess the impact of a newly developed competency-based marital and relationship education (MRE) program for couples in Curaçao, Dutch Caribbean. In consideration to the 57% divorce rate in Curaçao, and the view that intuition or cohabitation are the sole alternatives to marriage preparation in the Dutch Caribbean, a new additional alternative that is both intellectually defensible and empirically based was proposed. This quasi-experimental study used a sample of 310 participants aged 19-63 years. Using the Solomon design and planned contrast for one-way ANOVA, we compared pre-, post-intervention and follow-up results after 2.5 years of couples in a distress and adjusted group. Statistically significantly increased scores were obtained for (1) marital satisfaction, with an effect size (Cohen's d) of 2.18 for the adjusted group and 4.44 for the distressed group; (2) commitment (adjusted group d = 1.98, distressed group d = 2.90); and (3) the 12 profiled relationship competencies for marital durability (adjusted group d = 1.62, distressed group d = 6.27). Follow-up measurements conducted 2.5 years upon MRE program completion indicated that its effects were durable. We concluded that participation in the Profile of Durable and Successful Couples (PDSC) program resulted in increased marital satisfaction, relationship commitment, and mastery of the 12 profiled family and relationship competencies, that contribute to relationship durability. This implicate that the PDSC program under study can be adopted to prevent relationship erosion, while also assisting those experiencing relationship distress in finding satisfactory solutions. The competency-based focus of the program could be considered the matrix in maximizing the sustainable success of MRE program.

Resumen El objetivo de este estudio es evaluar el impacto de un nuevo programa de educación marital o relacional basado en el desarrollo de competencias familiares para parejas en Curazao, Caribe Holandés. La tasa de divorcio del 57% y la opinión de que la intuición o la cohabitación son las únicas alternativas a la preparación para el matrimonio en el Caribe Holandés demandan una alternativa adicional que no solamente sea intelectualmente defendible, sino que además tenga base empírica. Por esta razón hemos realizado un estudio tipo cuasi experimental en el cual se usó una muestra de 310 individuos de 19 a 63 años. Además, se implementó el diseño de Solomon y el contraste planeado para el ANOVA de una vía, en el cual comparamos los resultados obtenidos de antes y después de una intervención (i.e. curso de educación de parejas). Posteriormente hemos comparado los resultados después de 2.5 años para evaluar el carácter permanente de los resultados en dos grupos de parejas, parejas ajustadas y parejas con dificultades relaciones/ angustiados. Los resultados obtenidos indican puntuaciones significativamente elevadas para la variable (1) de satisfacción marital, con un tamaño de efecto (d=Cohen) de 2.18 para el grupo ajustado y 4.44 para el grupo angustiado; (2) compromiso (d del grupo ajustado = 1.98, d del grupo angustiado 2,90); y (3) las 12 competencias perfiladas para la durabilidad marital (d del grupo ajustado = 1.62 y grupo angustiado = 6.27). Hemos concluido que el programa aumentó la satisfacción marital, el sentido de compromiso con la relación y el dominio de las 12 competencias perfiladas para la familia o relaciones duraderas. Este estudio tiene la siguiente implicación: la sensibilidad cultural y el enfoque basado en desarrollo de competencias pueden ser cruciales y la matriz en la maximación del éxito sostenible de programas de educación relacional y marital como herramienta de intervención preventiva y/o de tratamiento.

Rapid assessment of avoidable blindness: Prevalence of blindness, visual impairment and diabetes in nuevo leon, Mexico 2014.

PURPOSE: To estimate the prevalence of blindness, visual impairment, diabetes mellitus, and diabetic retinopathy in patients aged 50 years and older in the State of Nuevo León, Mexico. METHODS: Ninety-one clusters of 60 people aged 50+ were selected randomly and a rapid assessment of avoidable blindness (RAAB) was conducted. Participants had their visual acuity and cause of visual impairment assessed, underwent a random glucose test and fundoscopy under mydriasis if they had diabetes. The diabetic retinopathy (DR) degree was classified according to the Scottish diabetic retinopathy grading scheme. RESULTS: From the sample 5,055 (92.6%) people were examined. The blindness prevalence was 1.7% (95% Confidence Interval: 1.3-2.1%). Cataract (32.6%), DR (29.1%) and glaucoma (16.3%) were the leading causes of blindness. The prevalence of severe, moderate, and early visual impairment was 1.0%, 5.1%, and 7.7%, respectively. Among respondents, 31% had diabetes and 8.1% of them was not diagnosed prior to the study. Of all participants with diabetes, 50% had glucose levels of 200 mg/dl or higher and 15.7% had sight-threatening diabetic retinopathy. CONCLUSIONS: Besides strengthening of cataract intervention activities, more ophthalmic services for diabetic retinopathy and glaucoma control are needed in Nuevo León to provide timely intervention to prevent blindness.

Laparoscopic extravesical ureteral reimplantation (LEVUR): a multicenter experience with 95 cases.

INTRODUCTION: Minimally invasive techniques have been used to treat vesicoureteral reflux (VUR) on pediatric patients. The aim of this study is to review the experience of the laparoscopic approach for VUR by the laparoscopic extravesical ureteral reimplantation (LEVUR) Lich-Gregoir technique. MATERIALS AND METHODS: We performed a multicentric retrospective study. From 2001 to 2009, 81 pediatric patients with VUR constituting 95 ureteral units underwent LEVUR. Reflux was grade II in 32%, grade III in 55%, and grade IV in 8%. RESULTS: LEVUR was performed successfully on the 81 patients with 95 ureteral units. Mean operative time was 105 minutes for left-sided reimplants, 70 minutes for right sided, and 180 minutes for bilateral reimplants. Mean hospital stay was 1.6 days. Urinary catheter was kept in place for a mean time of 0.5 days. Follow-up was achieved for at least 1 year with regular clinic visits, urinalysis, ultrasound, and voiding cystourethrogram. Four patients (4.2%) had evidence of recurrent VUR in a follow-up of 6 to 36 months after antireflux surgery. CONCLUSIONS: Although new endoscopic techniques have been widely available for VUR, they have a lower success rate and might require multiple attempts before success. We report that LEVUR has an acceptable success rate (95.8%) and durability compared with open and endoscopic procedures.

Totally laparoscopic approach for failed conventional orchiopexy.

INTRODUCTION: About 0.2-10% of patients with prior orchiopexy will require reoperation for recurrent cryptorchidism. The most common approach for these patients has been an open inguinal repeat orchiopexy. The aim of this report is to show results and feasibility with the totally laparoscopic approach for failed prior open orchiopexy. SUBJECTS AND METHODS: Nine patients with 11 recurrent undescended testes were treated by the totally laparoscopic orchiopexy approach. We used a four-port technique, starting with laparoscopic dissection of the vas deferens and spermatic vessels as high as possible in order to get adequate length of these structures. The inguinal internal ring was opened, and the testis was dissected to finally bring it into the abdominal cavity. A transcrotal trocar was introduced all the way to the abdominal cavity to finally pull through the testis into the scrotum. RESULTS: Laparoscopic orchiopexy was performed satisfactorily in all but 1 case in a mean time of 90 minutes. We did not experience any perioperative complications. In a mean follow-up of 25 months there has not been any recurrent cryptorchidism or atrophic testis. DISCUSSION: Laparoscopy offers the advantage of achieving an extensive mobilization of spermatic vessels and a careful dissection of the vas deferens. The totally laparoscopic approach for a failed orchiopexy represents a feasible, safe, and successful procedure.