Systemic sclerosis medications and risk of scleroderma renal crisis.

BACKGROUND: Scleroderma Renal Crisis (SRC) is associated with significant morbidity and mortality. While prednisone is strongly associated with SRC, there are no previous large cohort studies that have evaluated ace inhibitor (ACEi) calcium channel blocker (CCB), angiotensin receptor blocker (ARB), endothelin receptor blocker (ERB), non-steroidal anti-inflammatory drug (NSAID), fluticasone, or mycophenolate mofetil (MMF) use in systemic sclerosis (SSc) and the risk of SRC. METHODS: In this retrospective cohort study of the entire military electronic medical record between 2005 and 2016, we compared the use of ACEi, ARB, CCB, NSAID, ERB, fluticasone, and MMF after SSc diagnosis for 31 cases who subsequently developed SRC to 322 SSc without SRC disease controls. RESULTS: ACEi was associated with an increased risk for SRC adjusted for age, race, and prednisone use [odds ratio (OR) 4.1, 95% confidence interval (CI) 1.6-10.2, P = 0.003]. On stratified analyses, ACEi was only associated with SRC in the presence [OR 5.3, 95% CI 1.1-29.2, p = 0.03], and not the absence of proteinuria. In addition, a doubling of ACEi dose [61% vs. 12%, p < 0.001) and achieving maximum ACEi dose [45% vs. 4%, p < 0.001] after SSc diagnosis was associated with future SRC. CCB, ARB, NSAIDs, ERB, fluticasone, and MMF use were not significantly associated with SRC. CONCLUSION: ACEi use at SSC diagnosis was associated with an increased risk for SRC. Results suggest that it may be a passive marker of known SRC risk factors, such as proteinuria, or evolving disease. SSC patients that require ACEi should be more closely monitored for SRC.

Fathers' involvement in their children's healthcare.

Fathers' involvement in the routine healthcare of young children was investigated, and fathers' relative participation in two tasks, staying home with a sick child and taking the child to the doctor or dentist, was assessed. The relationships between fathers' involvement in healthcare and several other measures, including mothers' employment status, fathers' attitudes toward women's rights and roles, the amount of time fathers spent at work, and fathers' involvement in housework, were also examined. The subjects were 50 fathers of young children in intact, White, middle-class families. Both staying home with a sick child and taking a child to the doctor or dentist were usually performed by mothers, but when mothers were employed, fathers were significantly more involved, regardless of the child's sex. Staying home with a sick child and taking a child to the doctor or dentist were positively related to fathers' involvement in housework. Fathers' staying home with a sick child was significantly correlated with fewer hours at work and liberal attitudes toward women's rights and roles; these variables were not related to taking a child to the doctor or dentist. Positive correlations between fathers' involvement in housework and staying home with a sick child and taking a child to the doctor or dentist suggests that fathers' involvement in childcare is viewed as an aspect of family work.

A longitudinal study of fathers' involvement with young children: infancy to age 5 years.

A 4-year study was conducted to determine the temporal dynamics of paternal caregiving and play and the effect of maternal employment on these dynamics. The families were studied when the children were infants and again when they were 5 years old. At both times, the fathers were more involved in social interaction than in caregiving. Caregiving was usually provided by the mother, but the child's social interaction was equal for the father and mother. Paternal involvement in caregiving increased over time, whereas social interaction did not. The evidence indicates that maternal employment played a significant role in determining paternal involvement with the child as an infant and as the child grew older. When the child was an infant, the fathers' caregiving was positively related to the mothers' employment. Four years later, the fathers' caregiving and social involvement were positively related to the mothers' employment, and the parents' relative time available for involvement was positively associated with the fathers' participation in child care. The results are discussed in terms of the demand-response capacity hypothesis (Coverman, 1985).

Comparison of infants' reunion with fathers and mothers.

Each of 30 infants was observed during reunion with the father or mother in a nonstressful living room setting. Infants responded to reunion with fathers with an intense, brief display of socioemotional behavior toward them; reunion with mothers resulted in a more diffuse display. The findings suggest that, under nonstressful circumstances, infants behave in qualitatively different ways during reunion with fathers and mothers.

Fathers' involvement and responding to infants: "more" may not be "better".

It is commonly suggested that "more" involvement by fathers in infants' routine care may be "better"; however, support for this position is not conclusive. In the study reported here, a significant negative relationship was found between 27 fathers' involvement in their infants' care and positive responding to their infants in an observational setting. Several explanations are explored and discussed.

Psychological development in men: generativity and involvement with young children.

The personality development of 50 white men was investigated in terms of Eriksonian generativity and involvement with young children. Generativity was not related to caregiving; however, it was associated with social involvement. Generativity was also associated with several aspects of male personality including self-esteem, locus of control, and instrumentality.

Jewish affiliation in relation to suicide rates.

Jewish doctrine proscribes the taking of one's life, an admonishment which is apparently adhered to in the USA. A significant negative correlation (-.26) was found between 50 states' proportionate Jewish population and their suicide rates.

Feminism and anorectic tendencies in college women.

Anorexia is a debilitating disorder which affects significant numbers of young women. Brumberg has suggested a causal relationship in young women between feminism and anorexia. In this study, traditional-aged female college students completed the Attitudes Toward Women Scale and the Eating Attitudes Test. The hypothesized relationship between feminism and anorexia was not found.

Observations of Japanese men and children in public places: a comparative study.

The popular image of Japanese men, both in the United States and Japan, is that of "salaryman" who works such long hours that he has no time left for his children. The little empirical evidence available, however, suggests that Japanese men have familial involvement patterns not unlike those of men in the United States. In the study reported here, prepubertal children and adult males in Japan and the USA were observed together disproportionately more often during those times when men were not precluded (by work) from being with children. Further, during those periods children were more likely to be found in groups containing men rather than with women only. In both countries women continue to be the primary caregivers of children. However, previous research has shown that men in the USA, compared to men in other cultures, are not totally uninvolved; Japanese men are not either.