Weathering the Storm

This article examines the relationship between the family and work histories of older women and their personal incomes in later life, using retrospective data from the first 15 waves of the British Household Panel Survey. The association between women's family histories and their incomes later in life are relatively weak, explaining only a small proportion of the overall variation in older women's incomes. Divorce, early widowhood and re-marriage are not associated with any significant differences in older women's incomes, while motherhood is only associated with a small reduction in incomes later in life. While there are significant differences in the work histories of older women with different family histories, this translates into relatively small differences in their personal incomes, because the types of employment career pursued by most women are not associated with significantly higher retirement incomes and because public transfers dampen work history-related differentials, especially for widows. On the one hand, this could be seen as a positive finding in that the ‘pension penalty’ associated with life-course events such as motherhood and divorce is not as severe as often anticipated. On the other hand, the main reason for this is that the pension returns to working longer are relatively low, particularly for women with few qualifications. The analysis suggests that women retiring over the next two decades are unlikely to benefit significantly from the additional years they have spent in employment, because most of this increase has been in part-time employment. The article highlights the tensions between two objectives: rewarding work, and protecting the most vulnerable, such as carers, long-term disabled and unemployed. Resolving this dilemma involves moving away from a close association between pension entitlements and work history and towards universal entitlement based on a citizen's pension.

It has been well noted at this point that Buddhist studies has suffered from a disproportionate emphasis on its idealized ascetic representations. Family life has, as a result, been marginalized (if not entirely ignored).Recent scholarship has been broadening the conversation, challenging the worldview presented by popular textbook materials such as Walpola Rahula's What the Buddha Taught. The attempt to sever worldly attachments is certainly a key Buddhist goal, but it is not necessarily the practice around which all Buddhists organize their lives. Family ties have surely always bound Buddhist communities together, regardless of how impermanent those families might be or how easily such ties can lead to dukkha. Placing the spotlight on family life brings these ties and practices into focus.The articles in this collection do a wonderful job of describing messy moments that arise when families and religious institutions interact. Each article in its own way reminds us that religious communities are filled with families and that these families necessarily contribute to the organization of those communities. To use a classical Buddhist formula, Buddhist institutions and Buddhist families are deeply and inevitably interconnected. They can never be pulled apart into neatly separate categories. Buddhist clerics may function as institutional authorities in certain contexts, but the articles here remind us that clerics do not have their authority handed over to them in a social vacuum. On the contrary, Buddhist institutional power, in its various community settings, is invariably replete with social and familial ties and dynamics.We (the guest editors) find these articles suggest that the relationship between religious authority and family ties can be one of competition. Although none of the articles identifies competition as a feature of this dynamic, when read together, we see the highlighting of competition as a fascinating by-product of the contributors' analyses.Consider, for example, Joel Gruber's contribution. In it he examines two Ny ingma texts including Blazing Splendor, the memoirs of Tulku Urgyen, which, among other things, tells of his grandmother Konchok Paldron, a teacher in her own right. The family/ religious-authority connection is evident in its very authorship, but Gruber's study goes well beyond this obvious point. Gruber highlights a number of scenes in the text in which the religious establishment comes into conflict with Paldron's own family's history and needs. The most powerful example presented takes place when Konchok Paldron's son is identified as a tulku. After his identification, a monastic committee arrives at the house requesting that the child be handed over to them. The problem, however, is that they have come during a family funeral. Konchok Paldron therefore requests that they return at a more appropriate time. The monastic committee is offended, but does eventually leave, only to return not long thereafter with a much larger group with a more threatening demeanor. To avoid shedding blood, Konchok Paldron finally agrees to give her son away, but a few years later, after the drama appears to have subsided, she asks for permission to have her son visit her at home. The monastic authorities agree, and the son returns. She then refuses to send him back. According to the text, this is how she manages to get her revenge.This scene, as described by Gruber, functions as an extraordinary example of how families and religious institutions can find themselves in a tug-of-war over the children they each believe they have priority over. Elijah Ary, a tulku in the West, describes a similar tension arising around his own identification as a tulku.1 Gruber and Ary ask poignant questions: To whom does a child belong? Does the child belong to religious communities claiming to have power over the supramundane world, or does the child belong to the family? Or to both? And when, if ever, is the child empowered to be part of answering those questions? …

National Institutes of Health State-of-the-Science Conference Statement: Family History and Improving Health

This article explores the use of memory and material culture in the history of families who travelled between Britain and Australia and settled in the early colonies from 1788 until 1901. It draws on diaries, memoirs, letters, and objects belonging to a variety of cultural institutions including the Museum of Childhood in Perth, Museum Victoria, the Powerhouse Museum, and the Historic Houses Trust of New South Wales, as well as those within private collections, to explore some of the meanings of objects brought by families from Britain to Australia. Certain objects connected their owners with past lives back in Britain, reminded them of home, family ties and duty and were transferred to new owners to remind the next generation of their journeys round the world. It argues that a focus on material culture enriches our understanding of the economic, social and cultural history of the family in late eighteenth and nineteenth-century Britain and Australia and allows us to appreciate the labour of mothers in creating family histories.

Genetic counseling is “the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease.” Traditionally, this process includes collecting and interpreting the family and medical history, risk assessment, a comprehensive educational process for potential genetic testing, informed consent, and psychosocial assessment and support (National Society of Genetic Counselors' Definition Task Force et al. 2006). While genetic counseling falls within the scope of many health care professionals, clinical geneticists (physicians) and masters level genetic counselors have been working in the United States for more than 40 years, providing genetic counseling primarily for single-gene conditions. Debate about what “genomic counseling” will include and who will practice it has been fueled by the transition from single-gene focused genetic counseling and testing to a full genomic medicine approach. The routine incorporation of genomic medicine will likely induce differences in the scope, approach and process of genetic counseling (Table ​(Table1).1). In this commentary, I will discuss the several areas where practice will likely change as we move toward “genomic” counseling, with a focus on the unique skills and roles that genetic counselors and clinical geneticists provide. Table 1 Changes that will impact the transition to “genomic counseling.”

Introduction: Sleep disorders are an important risk for cardiovascular disease. Although the effects of sleep-disordered breathing have been widely studied in general populations, there is a gap in understanding its prevalence and determinants among South Asians in the United States of America (US), a group with high risk of cardiometabolic disease that presents unique genetic burdens and acculturation issues. We examined the association of family history of sleep disturbances and acculturation in a survey of South Asian immigrants. Methods: We surveyed 105 US South Asian participants (20-75 years, 69% male, 92% born in South Asia) recruited at a community event. Respondents provided information on age, gender, acculturation (measured by the adoption of English spoken at home), and family history of severe snoring in first degree relatives. We used a modified Berlin Sleep Questionnaire, where the obesity criterion was replaced with current diabetes to identify persons with high-risk sleep disturbances and asked about severe snoring in first degree relatives to identify family history of sleep disturbances. We examined the association of high-risk sleep disturbances with family history and acculturation metrics using Chi-squared tests, followed by logistic regression analysis. Results: Of the 105 participants, 28 (26.7%) were identified as high-risk for sleep disturbances. Those at high risk had a median age of 61 years, significantly older than their low-risk counterparts (median age 53; p=0.015). Of the 55% individuals who were acculturated to now speak English at home, 34% had high risk sleep disturbances as compared to 17% with sleep disturbances among those that continued to speak their native non-English language (p=0.044). Of the 10% individuals whose siblings had severe snoring problems, 50% had high risk sleep disturbances vs. 24% in those without sibling history (p = 0.079). In logistic regression models adjusting for age and gender, both sibling history (Odds Ratio 4.6, 95% CI 1.0 to 20.3, p = 0.047) and acculturation (Odds Ratio 3.0, 95% CI 1.1 to 8.6, p = 0.037) were associated with high-risk sleep disturbances. Conclusions: Acculturation as measured by adoption of English as the home language and family history of severe snoring are both associated with sleep disturbances among US South Asians in. Healthcare providers should be especially vigilant for sleep disorders in acculturated South Asian patients and those with such family and social history. Further studies are needed to understand the relationships between genetic predispositions, acculturation, and environmental factors in this population.

If reconstructing the past has been demonstrated to be an effective means of consolidating a sense of belonging to history-based groups, such as families and nations, then selective memory can be also a helpful tool in making, un-making, and remaking identities. This article examines the multifaceted, crucial role played by autobiographies and family histories in identities’ construction and deconstruction by focusing on the stories of about 100 foreigners settled in Restoration Naples. The negotiations over citizenship between these migrants and the Neapolitan government are investigated in order to demonstrate the inextricable relationships between family ties, family histories, nationhood, and citizenship in 19th-century Europe and to ascertain to what extent narrating the past helped people to manipulate their personal and national identities, despite the innovative technical and conceptual means introduced to identify individuals and distinguish citizens from foreigners throughout the revolutionary period.

Challenges With Colorectal Cancer Family History Assessment—Motivation to Translate Polygenic Risk Scores Into Practice

Histories of family in Britain through the 20th century have been written from a number of different perspectives and have taken a range of conceptual and analytical approaches. Autobiographical and biographical accounts have thrown much light on personal experience (Sage, 2001; Harding, 2006) and the effects of welfare encounters though which families with perceived were identified, regulated or supported (Steedman, 1986). Social histories of family lives have been equally revealing about the ways in which the constitution of normal family relationships has shifted over time (Gillis, 1997; Davidoff et al, 1999; Davidoff, 2012).Tracing, inter alia, demographic, economic, political and cultural change as well as shifts in gender relations, familial ties and patterns of employment, such accounts have illustrated the significance of context not only for understanding how the norms of family lives are always contingent and in flux, but also for mapping their continuities. Other accounts have been generated in legal and policy histories concerned with the more public arenas of political intervention and professional accountability around family troubles, wherein the work of government commissions, legislative reform and public inquiries has been interrogated (Parton, 2004; Cretney, 2005). There are also rich analyses that take as their focus a particular dimension of what would have been regarded as family in the past, such as unmarried motherhood (Evans and Thane, 2011), bereavement (Jalland, 2010), unemployment (Burnett, 1994), disability (Atkinson et al, 2003), migration (Webster, 1998), child abuse (Ferguson, 2004) and child poverty (Platt, 2005). These variously illustrate how experiences and discourses of troubles have changed and how, in turn, they have impacted upon and shaped the dynamics of family relationships and practices.

This paper examines the family ties of older adults in the United States and how they are associated with mental health and social activity. We compare older adults with 4 types of family ties: adults "close" to family in proximity and social network, "kinless" older adults without a partner or children, "distanced" adults who live far from close kin, and "disconnected" older adults who do not report kin in their social network or do not report a location for some kin. Using pooled data from the National Health and Aging Trends Study 2015-2019 for older adults aged 70 and older (N = 24,818 person-waves), we examine how family ties are associated with mental health and social activity, and whether lacking family is tied to poor well-being because older adults' needs are not being met. Kinless older adults and disconnected older adults have poorer outcomes (lower mental health scores and less social activity), compared to those close to their family. These findings suggest that both the presence and quality of the connection, as measured here via both location and social network, are critical for understanding which older adults are "at risk." Older adults who were not geographically proximate to their close kin (i.e., distanced) were not disadvantaged relative to those close to their families. Unmet needs do not help explain these patterns. Our results highlight that family ties are important for older adults well-being, not just through their existence but also their quality and strength.

ImportancePotentially harmful mutations of the breast cancer susceptibility 1 and 2 genes (BRCA1/2) are associated with increased risk for breast, ovarian, fallopian tube, and peritoneal cancer. For women in the United States, breast cancer is the most common cancer after nonmelanoma skin cancer and the second leading cause of cancer death. In the general population, BRCA1/2 mutations occur in an estimated 1 in 300 to 500 women and account for 5% to 10% of breast cancer cases and 15% of ovarian cancer cases.ObjectiveTo update the 2013 US Preventive Services Task Force (USPSTF) recommendation on risk assessment, genetic counseling, and genetic testing for BRCA-related cancer.Evidence ReviewThe USPSTF reviewed the evidence on risk assessment, genetic counseling, and genetic testing for potentially harmful BRCA1/2 mutations in asymptomatic women who have never been diagnosed with BRCA-related cancer, as well as those with a previous diagnosis of breast, ovarian, tubal, or peritoneal cancer who have completed treatment and are considered cancer free. In addition, the USPSTF reviewed interventions to reduce the risk for breast, ovarian, tubal, or peritoneal cancer in women with potentially harmful BRCA1/2 mutations, including intensive cancer screening, medications, and risk-reducing surgery.FindingsFor women whose family or personal history is associated with an increased risk for harmful mutations in the BRCA1/2 genes, or who have an ancestry associated with BRCA1/2 gene mutations, there is adequate evidence that the benefits of risk assessment, genetic counseling, genetic testing, and interventions are moderate. For women whose personal or family history or ancestry is not associated with an increased risk for harmful mutations in the BRCA1/2 genes, there is adequate evidence that the benefits of risk assessment, genetic counseling, genetic testing, and interventions are small to none. Regardless of family or personal history, the USPSTF found adequate evidence that the overall harms of risk assessment, genetic counseling, genetic testing, and interventions are small to moderate.Conclusions and RecommendationThe USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with BRCA1/2 gene mutations with an appropriate brief familial risk assessment tool. Women with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing. (B recommendation) The USPSTF recommends against routine risk assessment, genetic counseling, or genetic testing for women whose personal or family history or ancestry is not associated with potentially harmful BRCA1/2 gene mutations. (D recommendation)

In the United States, federal and state laws envision a variety of roles for management and non-management directors on corporate boards. At bottom, the proper and lawful performance of these roles, and the legitimacy of director decision-making and monitoring turns on the extent to which the directors exercise judgment without being unduly swayed by cognitive bias. A recent empirical study conducted by the Cultural Cognition Project at Yale University suggests that cultural-identity-protective cognition - a type of cognitive bias related to one's cultural worldview - influences risk assessment in the general population. This Article proposes that identity-protective cognition may influence systematically director behavior, including recommendations to dismiss shareholder derivative litigation, decisions regarding executive compensation, and director monitoring of conflict-of-interest transactions. Generally, courts and regulators assume that directors' risk assessment may be influenced by financial incentives and familial ties. Courts give greater scrutiny to a board's decision-making process if the process may be tainted by financial incentives and familial ties. Alternatively, courts give more deference to a board's decision-making process if the decision was made by directors who are free of financial and familial ties. However, courts and regulators assume that directors' risk assessment would not be influenced (at least not in any way that needs to be addressed by regulation) by other incentives, such as a need to protect one's cultural identity. While more research is needed to determine the extent of cultural-identity-protective risk assessment on board behavior, and such research should be informed by evidence from directors on their perceptions of their roles and functions, the theory of cultural-identity-protective cognition suggests that changes in corporate governance law and behavior are necessary to promote unbiased decision-making by directors. This Article proposes that such changes should include greater diversity in worldviews on corporate boards. Perhaps this diversity could be accomplished by assuring that directors are educated about different worldviews, and assigning a director (or board committee) the task of chief naysayer - someone whose questions would arise from worldviews not represented in the majority of the board. Also, courts may need to account for directors' identity-protective bias when reviewing directors' decisions.

Since the advent of genotyping, recognition of heritable disease has been perceived as an opportunity for genetic diagnosis or new gene identification studies to advance understanding of pathogenesis. Until recently, however, clinical application of DNA-based testing was confined largely to Mendelian disorders. Even within this remit, predictive testing of relatives is cost-effective only in diseases in which the majority of families harbor mutations in known causal genes, such as adult polycystic kidney disease and hypertrophic cardiomyopathy, but not dilated cardiomyopathy. Confirmatory genetic testing of index cases with borderline clinical features may be economic in the still smaller subset of diseases with limited locus heterogeneity, such as Marfan syndrome. Furthermore, Mendelian diseases account for ≈5% of total disease burden.1 Genome-wide association studies have made headway in elucidating the genetic contribution to the more common, complex diseases, and high throughput techniques promise to facilitate integration of genetic analysis into clinical practice. Nevertheless, many genes remain to be identified and implementation of genomic profiling as a population screening tool would not be cost-effective at present. The implications of heredity, however, extend beyond serving as a platform for genetic analysis, influencing diagnosis, prognostication, and treatment of both index cases and relatives, and enabling rational targeting of genotyping resources. This review covers acquisition of a family history, evaluation of heritability and inheritance patterns, and the impact of inheritance on subsequent components of the clinical pathway. Eliciting a family history is the first step to determining whether a known diagnosis is heritable or symptoms of unknown etiology have a hereditary basis. Both narrative and diagrammatic approaches are integral to data collection, the former including questioning for diseases that recur within the family and the latter involving construction of a pedigree or family tree. Incorporation of psychosocial and interactional data, such as emotional relationships (harmony, apathy, …

Diagnosis in paediatric genetics involves a combination of technologies able to display variation in DNA and clinical discussions with families that concentrate on retrieving family histories. This paper explores the significance of the family tales that genetics brings to the fore. Through discussion of an ESRC-funded ethnographic study of families referred to a paediatric genetic service, the paper explores how genetics and family history intersect in ‘relations of exchange’ ( Latimer, 2013 ). It draws from sociological work on family that emphasizes the importance of narrative to the formation and maintenance of family ties and the importance of broader social contexts to the kinds of stories that can be told and recognized by others. The paper emphasizes the significance of claims to respectability and value to the narratives people provide of family ties; particularly in contexts where such ties, in the past or the present, are thought of as ‘troubling’. Making reference to research by Skeggs and Loveday (2012) , it is argued that an important narrative that is drawn upon, in order to claim respectability, is that of being a good parent who protects their children from socially ‘risky relations’ so that a positive future as a ‘subject of value’ may be possible.

The age standardized (world) incidence (per 100000) of large bowel cancer in Lithuania is increasing: in 1993-1997 it was 25.6 for males and 16.8 for females; in 1998-2002 it was 30.4 and 19.1 respectively. Meanwhile the age standardized (world) cancer mortality remains without change: in the same periods it was 18.0 for males and 11.5 for females; 18.6 and 10.6 respectively. These epidemiological aspects are basically for start CRC screening in national population. The age for population screening recommended by EC is 50-74 years and the optimal participation rate to get better survival of CRC patients is 45-60% of population. Numerous studies have shown the risk of getting CRC is higher if a first-degree family member had the disease, and shows that your chances of surviving the disease may be influenced in part by your family ties. It hypothesized that patients with a family history of CRC might be more likely to get screened for the disease, finding tumors earlier, and are more likely to have a better prognosis. In addition to collecting family tree information help for recognition of hereditary cancer syndrome such as HNPCC, Peutz-Jeghers Polyposis, and FAP. The familial risk for CRC and effective cancer prevention become more important in individuals aged below 50-55 years. The study in Lithuania was aimed to prove more knowledge on familial CRC risk and the surveillance of family members at risk for large bowel malignancy. This study indicates that a positive family history of CRC can be recognized as a prognostic factor for individuals aged 25-39 years. Results shows that a positive family history was not a clear indicator of early stage diagnosis in the groups studied compared to the population.