[Medical care of adults with congenital heart diseases : Present and future]. / Medizinische Versorgung von Erwachsenen mit angeborenen Herzfehlern : Gegenwart und Zukunft.

Congenital heart diseases (CHD) are the most common types of congenital organ defects. Thanks to medical progress in congenital cardiology and heart surgery, most children with CHD reach adulthood. Despite primarily successful treatment residual and subsequent conditions as well as (non)cardiac comorbidities can influence the chronic course of the disease and lead to a higher morbidity and mortality. Adults with congenital heart disease (ACHD) in Germany are not tied to the healthcare structure despite the great need for aftercare. According to the results of the medical care of ACHD (MC-ACHD) study, ACHD centers and specialists in Germany are insufficiently perceived despite increased complication rates and the great need for specialist guidance. General practitioners and patients are not adequately informed about existing ACHD facilities. A better awareness of the ACHD problem should be created at the level of primary medical supply in order to optimize care and to reduce morbidity and mortality. Improved future-oriented patient care includes lifelong regular follow-up and the possibility of interdisciplinary, integrated medical care of CHD.

Report on a panel longitudinal study of college women's eating patterns and eating disorders: noncontinuum versus continuum measures.

The self-reported frequencies (prevalence and incidence) of eating patterns and disorders in a matched longitudinal sample of college women (N = 141) interviewed during their sophomore year (Time 1) and senior year (Time 2) were compared. The rate of eating disorders was assessed using a noncontinuum measure, the Eating Attitudes Test (Garner, Olmsted, Bohr, & Garfinkel, 1982), as well as continuum measures based on criteria in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1980). The noncontinuum measure revealed a prevalence rate of eating disorders per 2-year period comparable to that found in other studies of college student populations. The incidence rate per 2-year period was not of epidemic proportions. A sizable percentage of women appeared to get better from Time 1 to Time 2; a small percentage of women remained abnormal eaters. The continuum measurement uncovered a large group of women whose eating patterns were chronic but not severe enough to classify them as "abnormal" eaters. The implications of using different measures for defining and treating college women's eating disorders are discussed.

From high school to college: changes in women's self-concept and its relationship to eating problems.

A longitudinal panel study of a sample of college women was undertaken to assess changes in women's self-concept from high school to college and during their college years and the relationship between changes in self-concept ratings and eating disorders. Self-concept was measured at Time Change 1 (senior year of high school to sophomore year of college), Time Change 2 (sophomore year of college to senior year of college), and Time Change 3 (senior year of high school to senior year of college) using Brownfain's (1952) self-rating scale. Eating behavior in college was measured at two points, sophomore and senior year, by the Eating Attitudes Test (Garner, Olmsted, Bohr, & Garfinkel, 1982). The women were placed into three eating groups: Group 1 (eating pattern becomes or remains abnormal). Group 2 (eating pattern gets better), and Group 3 (eating pattern remains normal). Results revealed that all women's self-concept ratings declined in Time 1 with only a slight increase on a few traits in Time 2. Analysis of variance (ANOVA) showed that Group 1 experienced a significant overall decline in self-concept ratings between Time 1 and Time 3 compared with Group 2 and Group 3. Group 2 reported significantly greater increases in assertiveness at Time 1 compared with Group 3. We suggest an interactional model for understanding the relationship between self-concept and eating problems.

Vaginoplasty for gender confirmation.

Male-to-female surgery for properly diagnosed gender dysphoria, conducted as an interdisciplinary rehabilitation program, may be a valid endeavor in many cases. Successful surgical results have been obtained by those skilled in this type of surgery.

The differential importance of weight and body image among college men and women.

Among a sample of American college students, body image and the degree of desired weight change were associated with academic self-rankings, with social and psychological well-being, and with the development of eating difficulties. The effects of body image and desired weight change on eating disorders were generally found to be greater for women than for men, and their effects on student self-rankings of academic ability, social, and psychological traits were more pervasive for women than for men. The less attractive a woman perceived herself to be and the more weight she wanted to lose, the greater was her overall sense of academic, social, and psychological impairment. Women who had poor body images and who desired to lose weight were more likely to report eating difficulties.

On the expression of H-Y antigen in transsexuals.

Histocompatibility-Y (H-Y) antigen, the presumptive inducer of the mammalian testis, is present in the cells of normal males and not in the cells of normal females. Recent reports have implied that patients with transsexualism exhibit H-Y antigen phenotypes at variance with those of normal males and females and, thus, that H-Y serology might provide a tool for the diagnosis and study of the transsexual condition. We therefore evaluated blood and testicular cells from 21 male-to-female transsexuals using conventional and monoclonal H-Y antibodies. We found no evidence of abnormal H-Y phenotype. Five of the patients were interviewed postoperatively by two examiners and rated for the diagnosis of transsexualism. Three of the five were rated primary transsexual by one or both examiners, and two were rated secondary transsexual.

Resource theory and power in families: life cycle considerations.

We begin our discussion by outlining the usefulness of "resource theory" as a theoretical framework for the study of family power. This framework is then used to analyze changes in the balance of power between elderly parents and their middle-age children. With respect to intergenerational power relationships, we argue that the autonomy of elderly parents has increased, but their power and influence over adult children has decreased. This trend is likely to continue in coming decades. Resource theory is then utilized to analyze changes in marital power relationships as couples age. Most studies of power relationships between elderly spouses have an important limitation--they tend to reflect yesterday's definitions of male and female roles. Recent changes in these roles may significantly alter the social meanings of aging for both men and women in coming years.