Chronic stress exposure, social support, and sleep quality among African Americans: findings from the National Survey of American Life-Reinterview.

OBJECTIVE: The purpose of this study was to determine whether social support from extended family and church members moderate the association between chronic stress exposure and sleep quality in a nationally representative sample of African American adults. DESIGN: Data from African American respondents aged 18 and older were drawn from the National Survey of American Life-Reinterview. The analytic sample for this study included 1,372 African American adults who attended religious services at least a few times a year, as the church-based relationship measures were only assessed for these individuals. Self-reported sleep quality was assessed by sleep satisfaction, trouble falling asleep, and restless sleep. Chronic stress exposure was measured by a nine-item index. OLS and logistic regression were used to estimate the relationship between chronic stress exposure, extended family and church relationships, and sleep quality. RESULTS: The data indicated that chronic stress exposure was associated with decreased sleep satisfaction, increased likelihood of trouble falling asleep and restless sleep. Receiving emotional support from family and more frequent contact with church members were associated with decreased restless sleep. Emotional family support moderated the associations between chronic stress exposure and trouble falling asleep and restless sleep. The positive associations between chronic stress exposure and these two sleep quality measures were attenuated among respondents who received high levels of emotional support from their family. CONCLUSIONS: Together, these findings underscore the detriment of chronic stress exposure to African Americans' sleep quality and suggest that extended family members are effective stress coping resources and play an important role in this population's sleep quality.

Annual Research Review: Towards a deeper understanding of nature and nurture: combining family-based quasi-experimental methods with genomic data.

Distinguishing between the effects of nature and nurture constitutes a major research goal for those interested in understanding human development. It is known, for example, that many parent traits predict mental health outcomes in children, but the causal processes underlying such associations are often unclear. Family-based quasi-experimental designs such as sibling comparison, adoption and extended family studies have been used for decades to distinguish the genetic transmission of risk from the environmental effects family members potentially have on one another. Recently, these designs have been combined with genomic data, and this combination is fuelling a range of exciting methodological advances. In this review we explore these advances - highlighting the ways in which they have been applied to date and considering what they are likely to teach us in the coming years about the aetiology and intergenerational transmission of psychopathology.

The Swedish Kinship Universe: A Demographic Account of the Number of Children, Parents, Siblings, Grandchildren, Grandparents, Aunts/Uncles, Nieces/Nephews, and Cousins Using National Population Registers.

Given that surprisingly little is known about the demography of human kinship, we provide a demographic account of the kinship networks of individuals in Sweden in 2017 across sex and cohort between ages 0 and 102. We used administrative register data of the full population of Sweden to provide the first kinship enumeration for a complete population based on empirical data. We created ego-focused kinship networks of children, parents, siblings, grandchildren, grandparents, aunts and uncles, nieces and nephews, and cousins. We show the average number of kin of different types, the distribution of the number of kin, and changes in dispersion over time. A large share of all kin of an individual are horizontal kin, such as cousins. We observe the highest number of kin-on average, roughly 20-around age 35. We show differences between matrilineal and patrilineal kin and differences in the kinship structure arising from fertility with more than one childbearing partner, such as half-siblings. The results demonstrate substantial variability in kinship within a population. We discuss our findings in the context of other methods to estimate kinship.

Factors contributing to the quality of life among Thai patients diagnosed with colorectal cancer with a stoma: An integrative review.

AIM: To appraise and synthesize research investigating the factors contributing to the quality of life (QOL) among Thai patients diagnosed with colorectal cancer (CRC) with a stoma. DESIGN: An integrative review. DATA SOURCES: The scientific databases CINAHL, Medline, PubMed, Web of Science, Google Scholar and ThaiJO were queried for English or Thai research articles published between 2011 and 2021. REVIEW METHODS: Included studies were searched utilizing the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines. The eligible studies were critically appraised by evaluating the study level and quality using the John Hopkins Research Evidence Appraisal Tool. Whittemore and Knafl's five-stage framework was used to guide this integrative review. Primary data from each suitable study were abstracted, coded and categorized into sub-themes. Finally, themes were identified based on the review question and objective. RESULTS: Eight articles met the inclusion criteria. Twelve sub-themes and five significant themes were identified: Sociodemographic and clinical, physiological, psychological, social and spiritual aspects. CONCLUSION: Factors contributing to QOL among Thai CRC ostomates can be categorized into five domains. The sociodemographic and clinical, physiological and psychological aspects are similar to those in other countries. In the meanwhile, the social and spiritual domains differ from those in other countries, particularly in extended family support and Buddhist belief. IMPACT: By providing the QOL contributing factors, nurses can investigate the significant QOL predictors and create the appropriate interventions for promoting QOL, specifically among Thai CRC adults with a stoma. Likewise, it will be helpful to integrate this result into the nursing curriculum in Thailand and other similar countries to teach nursing students who could give direct holistic care to CRC adults with a stoma. In addition, it will serve as the basis for healthcare policy regarding nursing practice guidelines for assessing the individuals' QOL factors and promoting QOL activities after ostomy surgery. Patient or Public contribution: The ostomy nurses in Thailand are involved in the data analysis stage. They read all the included studies before the meeting. They considered and commented on the generating and synthesizing of codes, subthemes and themes.

Kinship and socio-economic status: Social gradients in frequencies of kin across the life course in Sweden.

The influence of kin on various outcomes is heavily debated. However, kinship size itself conditions the probability of potential effects. Socio-economic gradients in the prevalence, variance, and types of kin are, therefore, a vital aspect of the functions of kin. Unfortunately, these parameters are largely unknown. We used Swedish register data to enumerate consanguine and in-law kin across the life course of the 1975 birth cohort. We calculated differences in kinship size between this cohort's income quartiles and educational groups. We decomposed how specific kin relations, generations, and demographic behaviours contributed to these differences. Among low socio-economic status (SES) groups, higher fertility in earlier generations resulted in more kin compared with high-SES groups. Low-SES groups had more horizontal consanguine kin, while high-SES groups had more in-laws. Lower fertility and higher union instability among low-SES men substantially narrowed SES differences in kinship size. Kinship size varied substantially within SES groups.

Fictive Kin Networks among African Americans, Black Caribbeans, and Non-Latino Whites.

Using data from the National Survey of American Life, we investigated the social and demographic correlates of fictive kin network involvement among African Americans, Black Caribbeans, and non-Latino Whites. Specifically, we examined the factors shaping whether respondents have fictive kin, the number of fictive present kin in their networks, and the frequency with which they received support from fictive kin. Eighty-seven percent of respondents had a fictive kin relationship, the average network size was 7.5, and 61% of participants routinely received fictive kin support. Affective closeness and contact with family, friends, and church members were positively associated with fictive kin relations. Age, region, income and marital and parental status were related to fictive kin network involvement, though these associations varied by race/ethnicity. Collectively, findings indicate that fictive kin ties extend beyond marginalized communities, and they operate as a means to strengthen family bonds, rather than substitute for family deficits.

African Children Vulnerabilities in COVID-19 Era: A Review.

The pandemic of COVID-19 has spread from China to the whole world. Here we address the vulnerability of African children in the context of this health crisis. Based on medical, socio-economic and anthropological studies, we present a thematic review that examines the issue at three levels. Firstly, we address the question of the effect of the virus on children in regard to strategies implemented to limit its spread and the capacity of medical devices in Africa. Second, we address the issue of the additional disruptions that the virus could generate by infecting the parents or guardians of children who often find themselves subject to the disquietudes of an informal economy. Finally, we discuss the long-term effects of the crisis on children about food security issues, particularly in relation to overweight and obesity. Based on studies that have documented the long-term overweight risks that can occur due to school cessation as a result of lockdown measures, we provide strategies to address this emerging public health problem in Africa. We conclude the study by suggesting that all these forms of vulnerabilities remain proactive areas of work to better prepare Africa for future pandemics.

The genetic and environmental etiology of child maltreatment in a parent-based extended family design.

Child maltreatment has been associated with various cumulative risk factors. However, little is known about the extent to which genetic and environmental factors contribute to individual differences between parents in perpetrating child maltreatment. To estimate the relative contribution of genetic and environmental factors to perpetrating maltreatment we used a parent-based extended family design. Child-reported perpetrated maltreatment was available for 556 parents (283 women) from 63 families. To explore reporter effects (i.e., child perspective on maltreatment), child reports were compared to multi-informant reports. Based on polygenic model analyses, most of the variance related to the perpetration of physical abuse and emotional neglect was explained by common environmental factors (physical abuse: c2 = 59%, SE = 12%, p = .006; emotional neglect: c2 = 47%, SE = 8%, p < .001) whereas genetic factors did not significantly contribute to the model. For perpetrated emotional abuse, in contrast, genetic factors did significantly contribute to perpetrated emotional abuse (h2 = 33%, SE = 8%, p < .001), whereas common environment factors did not. Multi-informant reports led to similar estimates of genetic and common environmental effects on all measures except for emotional abuse, where a multi-informant approach yielded higher estimates of the common environmental effects. Overall, estimates of unique environment, including measurement error, were lower using multi-informant reports. In conclusion, our findings suggest that genetic pathways play a significant role in perpetrating emotional abuse, while physical abuse and emotional neglect are transmitted primarily through common environmental factors. These findings imply that interventions may need to target different mechanisms dependings on maltreatment type.

Typology of Social Network Structures and Late-Life Depression in Low- and Middle-Income Countries.

BACKGROUND: Rapid social changes and youth migration ensures a continuous drain on the social networks of the elderly in Low- and Middle-Income Countries (LMICs). OBJECTIVE: We reviewed available literature on the relationship between social network structures and depression among community dwelling older persons in LMICs with a view to identifying patterns that might provide information for designing preventive psychosocial interventions. METHODS: We searched the MEDLINE database through Pubmed, extracted information on the typologies of social network structures in LMICs and identified dimensions with the strongest systematic association with late-life depression, by weight, using the inverse of variance method. All analyses were conducted using the Cochrane review manager version 5.3. RESULTS: Fourteen community-based surveys drawn from 16 LMIC contexts met criteria for syntheses. They included a total of 37,917 mostly female (58.8%) participants with an average age of 73.2 years. Social network size, contact with network, diversity of network, co-residency with own child, having more friends than family in the network, and prestigious standing of persons in the social network were protective structures against late-life depression. Conversely, low network diversity contributed 44.2% of the weight of all social network structures that are predictive of late-life depression. CONCLUSION: Recommendations are made for the design of new measures of social network structures in LMICs that captures the key dimensions identified. Epidemiological studies using such tools will provide more precise information for planning and prioritization of scarce resources for the prevention of late-life depression in LMICs.

The paradoxical body: A glimpse of a deeper truth through relatives' stories.

BACKGROUND: People with progressive cancer experience that their bodies change due to disease and/or treatment. The body is integral to the unity of the human being, a unity that must be perceived as whole if dignity shall be experienced. Relatives are in touch with the suffering bodies of their dear ones, physically, socially, mentally, and existentially, and thus the relatives' experiences of the bodies of their dear ones might yield insight into the concept of dignity. AIM: The aim of this study is to explore relatives' experiences of the patients' bodily changes from a perspective of dignity. RESEARCH DESIGN AND METHOD: A total of 12 relatives from a hospice in Norway were interviewed. Gadamer's ontological hermeneutics inspired the interpretation. ETHICAL CONSIDERATIONS: The principles of voluntariness, confidentiality, withdrawal, and anonymity were respected during the whole research process. The Norwegian Social Science Data Services approved the study. RESULTS AND CONCLUSION: The conversations about the body were conversations about ambivalent or paradoxical matters that shed light on the concept of dignity. The results show that the relatives got in touch with elements that otherwise would have remained tacit and unspoken, and which gave glimpses of a deeper truth, which might reveal the core of dignity. Furthermore, the relatives' confirmation of the ambivalence might be understood as a strong ethical obligation to treat the other with dignity. The confirmation may also reveal the relatives' unselfish love of the other, which can be understood as the core of ethics and ethos. Finally, the results reveal the relatives' limited insight into their dear ones' bodily changes, and we discuss the challenges of truly seeing the other. Body knowledge and the relationship between body and dignity as phenomena cannot be ignored and needs more attention and articulation in clinical nursing practice and in nursing research.

Revisiting the Children-of-Twins Design: Improving Existing Models for the Exploration of Intergenerational Associations.

Datasets comprising twins and their children can be a useful tool for understanding the nature of intergenerational associations between parent and offspring phenotypes. In the present article we explore structural equation models previously used to analyse Children-of-Twins data, highlighting some limitations and considerations. We then present new variants of these models, showing that extending the models to include multiple offspring per parent addresses several of the limitations discussed. Accompanying the updated models, we provide power calculations and demonstrate with application to simulated data. We then apply to intergenerational analyses of height and weight, using a sub-study of the Norwegian Mother and Child Cohort (MoBa); the Intergenerational Transmission of Risk (IToR) project, wherein all kinships in the MoBa data have been identified (a children-of-twins-and-siblings study). Finally, we consider how to interpret the findings of these models and discuss future directions.

Extended family households among children in the United States: Differences by race/ethnicity and socio-economic status.

This study uses nationally representative longitudinal data from the Panel Study of Income Dynamics, to examine the prevalence and predictors of extended family households among children in the United States and to explore variation by race/ethnicity and socio-economic status (SES). Findings suggest that extended family households are a common living arrangement for children, with 35 per cent of youth experiencing this family structure before age 18. Racial/ethnic and SES differences are substantial: 57 per cent of Black and 35 per cent of Hispanic children ever live in an extended family, compared with 20 per cent of White children. Further, 47 per cent of children whose parents did not finish high school spend time in an extended family, relative to 17 per cent of children whose parents earned a bachelor's degree or higher. Models of predictors show that transitions into extended families are largely a response to social and economic needs.

Like an ace up the sleeve: an interview study of nurses' experiences of the contact with relatives in a somatic emergency ward.

Research indicates that active involvement of patients' relatives generally has a positive impact on patients' hospitalisation, including patient safety. Campaigns urge relatives to ask questions in relation to nursing care and treatment to enhance patient safety and to increase involvement of both patient and relatives. The question is how nurses experience relatives who ask questions. The aim of this study was to explore how nurses experienced contact with patients' relatives during admissions to a somatic emergency ward including nurses' experience of relatives asking questions related to nursing care and treatment. Six nurses were interviewed. The participants gave written consent to participate after receiving both oral and written information about the study. Data were analysed using combined theory and data-driven qualitative content analysis. The findings formed three main themes: (i) relatives' involvement as a means to efficiency during hospitalisation, (ii) relatives welcomed on the terms of the system and (iii) tension between high ideals and frustrating realities. The six interviews answered the research questions. However, more interviews could have broadened the study and contributed with further details. The nurses experienced relatives as an important resource - 'an ace up the sleeve', while reality seemed to challenge the relationship between nurses and relatives. The study contributes to discussions before development and implementation of specific initiatives aiming at increasing involvement of relatives of patients in a somatic emergency ward.

The Discourse of Gifting in Embryo Donation: The Understandings of Donors, Recipients, and Counselors.

In New Zealand, embryo donation (ED) is "open," allowing offspring to access genetic information. Donors and recipients meet prior to donation. Drawing on interviews with 15 recipients, 22 donors, and nine counselors, this article discusses how ED may be constructed as a form of gifting. This discourse may evoke expectations that recipients will express gratitude for the gift, including through honoring contact agreements. Donation becomes a relational practice of obligations and counter-obligations. However, the gift discourse may not adequately capture the emotional sacrifice experienced by donors. Donors describe significant attachment to their embryos, ambiguity about relinquishment, and interest in offsprings' welfare. Furthermore, embryos may be constructed as inalienable bodily gifts resulting in children with whom the donors share immutable social ties. A discourse of ED as mutual exchange, collaboration, and extended family building may be more useful to donors and recipients in managing ED.

"I Want to Go Gently": How AIDS Patients in Ghana Envisage Their Deaths.

This article examines the views of persons living with AIDS about how they want to die and how they are planning for their deaths. Participants for the study were purposefully drawn from an HIV clinic in an urban town in Ghana. In-depth interviews were conducted with 25 persons living with AIDS. Three preferences of death were identified by the participants. These include the desire for a quick death, death at home, and death without emaciating. Planning for death involved attending church and taking care of children. Inherent in the responses of the participants is the concern for cost of care, dwindling network of family carers, and stigmatization and shame. The article concludes that the government needs to provide support for home-based care, establish a pension for AIDS patients, support families to pay for the funeral expenses of their relatives, and scale up effort to reduce HIV/AIDS-related stigma.

Relatives perception of writing diaries for critically ill. A phenomenological hermeneutical study.

BACKGROUND: Diaries written by nurses for the critically ill patient help the relatives cope and support the patient. Relatives may participate in writing a diary for the critically ill and when they do this is appreciated by the patients. However, the relative's perception of writing a diary has not previously been explored. AIM: To explore how relatives perceive writing a diary for the critically ill patient. METHOD: In a phenomenological-hermeneutic study building on the theory of Ricoeur interviews with seven relatives were conducted and interpreted. FINDINGS: When relatives wrote a diary for the critically patients, they experienced that writing and reading the diary allowed for the unloading of emotions and expression of feelings. Writing a diary was a meaningful activity while enduring a situation of uncertainty and furthermore it created a distance that allowed understanding of the critical situation. CONCLUSION: Involving relatives in writing a diary may support relatives and help them cope with the critical situation. RELEVANCE TO CLINICAL PRACTICE: Relatives are distressed and struggle to understand what is happening during the patient's course of illness. Involving relatives in writing a diary for the critically ill could be one way to meet their needs in the critical situation.

Social support from church and family members and depressive symptoms among older African Americans.

OBJECTIVE: This study examined the influence of church- and family-based social support on depressive symptoms and serious psychological distress among older African Americans. METHODS: The analysis is based on the National Survey of American Life. Church- and family-based informal social support correlates of depressive symptoms (CES-D) and serious psychological distress (K6) were examined. Data from 686 African Americans aged 55 years or older who attend religious services at least a few times a year are used in this analysis. RESULTS: Multivariate analysis found that social support from church members was significantly and inversely associated with depressive symptoms and psychological distress. Frequency of negative interactions with church members was positively associated with depressive symptoms and psychological distress. Social support from church members remained significant but negative interaction from church members did not remain significant when controlling for indicators of family social support. Among this sample of churchgoers, emotional support from family was a protective factor and negative interaction with family was a risk factor for depressive symptoms and psychological distress. CONCLUSION: This is the first investigation of the relationship between church- and family-based social support and depressive symptoms and psychological distress among a national sample of older African Americans. Overall, the findings indicate that social support from church networks was protective against depressive symptoms and psychological distress. This finding remained significant when controlling for indicators of family social support.

Family structure and multiple domains of child well-being in the United States: a cross-sectional study.

BACKGROUND: We examine the association between family structure and children's health care utilization, barriers to health care access, health, and schooling and cognitive outcomes and assess whether socioeconomic status (SES) accounts for those family structure differences. We advance prior research by focusing on understudied but increasingly common family structures including single father families and five different family structures that include grandparents. METHODS: Our data on United States children aged birth through 17 (unweighted N = 198,864) come from the 1997-2013 waves of the National Health Interview Survey, a nationally representative, publicly available, household-based sample. We examine 17 outcomes across nine family structures, including married couple, cohabiting couple, single mother, and single father families, with and without grandparents, and skipped-generation families that include children and grandparents but not parents. The SES measures include family income, home ownership, and parents' or grandparents' (depending on who is in the household) employment and education. RESULTS: Compared to children living with married couples, children in single mother, extended single mother, and cohabiting couple families average poorer outcomes, but children in single father families sometimes average better health outcomes. The presence of grandparents in single parent, cohabiting, or married couple families does not buffer children from adverse outcomes. SES only partially explains family structure disparities in children's well-being. CONCLUSIONS: All non-married couple family structures are associated with some adverse outcomes among children, but the degree of disadvantage varies across family structures. Efforts to understand and improve child well-being might be most effective if they recognize the increasing diversity in children's living arrangements.

Congenital three generation wide familial non-syndromic polydactyly.

Polydactyly is typically observed as isolated and sporadic occurrences, although familial cases do exist, albeit with lower frequency, manifesting in various inheritance patterns. In around 30% of polydactyly cases, there exists a familial history, suggesting the probable involvement of a single gene. Given its potential for hereditary transmission, thorough investigation of the patients' parents, first-degree relatives, grandparents, and even great-grandparents for similar disorders becomes imperative. In our clinic, we conducted an analysis focusing on patients presenting with foot polydactyly, along with occurrences of polydactyly among their first- and second-degree relatives spanning two to three generations of family history. The study encompassed three patients and their respective families, including a pair of siblings. We speculate that the inheritance type in our cases was autosomal dominant. Among our patients, one presented with central polydactyly, while the remaining patients and all familial cases displayed postaxial polydactyly. In terms of morphologic classification, one patient had a Y-shaped metatarsal, another had a T-shaped metatarsal, and the third patient exhibited a duplicated ray-shaped anomaly. In our review of the literature, we haven't come across a case spanning three generations like the ones we encountered. Additionally, the presence of a transverse accessory extensor tendon between both extensor tendons in cases with T- and Y-shaped metatarsals intrigued us from an anatomical perspective. Our goal is to present these rare cases of congenital familial polydactyly spanning three generations, highlighting the anatomical variations observed and aiming to contribute to the existing body of literature on the subject.