Individual Family Units Research Articles

Effectiveness of family interventions for patients with schizophrenia: A systematic review and meta-analysis.

The family is the primary caregiver for most patients with schizophrenia, and their roles are essential in patients' illness trajectories and outcomes. Due to this, various family interventions for schizophrenia have been developed and applied to the relatives who take care of their family members with schizophrenia. This study examined the effectiveness of existing family interventions for schizophrenia in achieving their target outcomes at both the family and patient levels by utilizing a systematic review and meta-analysis. Combinations of terms were used to search for relevant studies from the databases. Thirty-seven randomized controlled trials that met the inclusion criteria were included in the analysis. Based on the pooled result of the included studies, the programmes significantly improved the targeted outcomes with large effect size. The programmes' impacts on family-related outcomes were higher than those on patients. Among the targeted outcomes, patients' treatment satisfaction and adherence and family caregivers' mental health were the most remarkable outcomes that had improved from the included programmes. Conversely, outcomes related to family relationships, caregiving experiences, perceived social support of family caregivers, and patients' medication use did not see significant improvements. The programmes delivered to individual family units and only to the family caregivers were more effective than those delivered to groups of caregivers and caregivers and patients together, respectively. Programme-focused interventions were more effective than emotion-focused ones. Based on these findings, an in-home visiting nurse programme or advanced technology is suggested when applying family interventions for schizophrenia in practice.

CULTURAL ECOFEMINISM IN CHARLOTTE PERKINS GILMAN’S FEMINIST UTOPIAN VISION AND ITS LIMITATIONS

Charlotte Perkins Gilman was an American feminist author of fiction and non-fiction, lecturer and sociologist of the late 19th, early 20th centuries. She integrates her sociological commentary into her ecofeminist vision for an alternative community consisting merely of women in her utopian fiction Herland published in 1915. The community she envisioned can best be read through the lens of cultural ecofeminism with her essentialist view of women’s innate tendency to uphold the sanctity of the environment opting for a peaceful coexistence rather than patriarchal domination. Since men are considered to be impediments to such a coexistence, they are absent from the utopian vision based on sisterhood of all women where they breed through parthenogenesis and raise their daughters as a community rather than in individual family units. Familial relations are not entirely eliminated, rather, as all Herlanders descend from a common maternal ancestor, are biologically as well as culturally connected.

Adherence rates and risk factors for suboptimal adherence to secondary prophylaxis for rheumatic fever.

AimSecondary prophylaxis with 3–4 weekly benzathine penicillin G injections is necessary to prevent disease morbidity and cardiac mortality in patients with acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This study aimed to determine secondary prophylaxis adherence rates in the Far North Queensland paediatric population and to identify factors contributing to suboptimal adherence.MethodsA retrospective analysis of data recorded in the online RHD register for Queensland, Australia, was performed for a 10‐year study period. The proportion of benzathine penicillin G injections delivered within intervals of ≤28 days and ≤35 days was measured. A multi‐level mixed model logistic regression assessed the influence of age, gender, ethnicity, suburb, Accessibility and Remoteness Index of Australia class, number of people per dwelling, Index of Relative Socio‐economic Advantage and Disadvantage, Index of Education and Occupation, year of inclusion on an ARF/RHD register and individual effect.ResultsThe study included 277 children and analysis of 7374 injections. No children received ≥80% of recommended injections within a 28‐day interval. Four percent received ≥50% of injections within ≤28 days and 46% received ≥50% of injections at an extended interval of ≤35 days. Increasing age was associated with reduced delivery of injections within 35 days. Increasing year of inclusion was associated with improved delivery within 28 days. The random effect of individual patients was significantly associated with adherence.ConclusionsImproved timely delivery of secondary prophylaxis for ARF and RHD is needed as current adherence is very low. Interventions should focus on factors specific to each individual child or family unit.

The one-humped camel in somaliland

Somaliland is a self-proclaimed republic located in the Horn of Africa. The country has adopted the same borders as the former British Somaliland Protectorate but it has had difficulties in gaining international recognition. Its area of 68 000 square miles (176 120 square kilometres) is home to about 4 million people. Sheep and goats each number more than 8 million head, camels 1.7 million and cattle 0.40 million. Livestock are the basis of the livelihoods of the majority of the nation's people. The camel has always been an icon in the culture and customs of the ethnic Somali. The British administration organised a Camel Corps to help in the maintenance of law and order in the then Protectorate but it also distinguished itself against the troops of Italian Somaliland in the World Wars of 1914–1918 and 1939–1945 before it was disbanded in 1946. As well as being important in the cultural fabric of the inhabitants of Somaliland, the camel is the major source of milk in the country, provides meat, performs transport operations and contributes its hides to the economy. Livestock in general are the major source of foreign exchange earnings to which camels contribute a considerable proportion. Feed is generally a problem and some has to be imported from Ethiopia. The presence of many diseases is a major constraint to the higher output which would be of great benefit to the welfare of the nation and of individual households and family units.

Our babies[’] count[er story]: A narrative ethnography of a baby loss remembrance walk ritual

ABSTRACTThe non-profit organization Now I Lay Me Down to Sleep (NILMDTS) hosts annual remembrance walks that gather bereaved families to honor babies who have died. Grounded in narrative theory and research on family communication rituals, the present study focused on understanding how the NILMDTS Remembrance Walk counternarrates the experience of baby loss vis-à-vis the master narrative that silences it. Our narrative ethnography included participating alongside approximately 1375–1600 bereaved family members, respectively, in the 2014 and 2015 Remembrance Walks taking place in Littleton, Colorado. Two interwoven counternarratives resisted the master narrative. The communal loss narrative centered community-building for families and the individual loss narrative emphasized the unique identities of babies, as well as their individual family units and members.

Writing new branches into being: Connecting donor-linked families via Web 2.0

Abstract Families that are linked by having chosen the same sperm donor are increasingly locating and connecting with each other online. Focusing primarily on queer-parented, donor-linked families, this article examines the ways in which parents are simultaneously adhering to and rebelling against heavy cultural emphasis on genealogical roots as a source of self-knowledge and identification. Emerging now via online media is a live chronicling of the shifting nature of family and kinship which pushes against borders that are commonly believed to be static in nature. Quick media allows not only for the volume of personal narrative to be increased but the coming together of these voices begins to disrupt the hegemony and reshape the narrative itself. This interactive shift also impacts the way in which parents develop a parental and family identity as online engagement shapes the reader and in turn shapes what is written. Within this article, donor-linked families are referred to as ‘dibling families’. The colloquial term ‘dibling’ refers to a donor sibling, creating a distinction between siblings within an individual family unit, while acknowledging a shared genetic connection between the children. In choosing to be connected (to varying degrees), dibling families are exemplifying hybridized family forms that reimagine, rather than completely reify or reject, traditional notions of kinship.

EQUITÀ E WELFARE STATE EUROPEO

Equity is a fundamental concept for the efficient functioning of the market mechanism. The minimum and maximum limits of distributive equity are analysed on a theoretical level to demonstrate how the functioning of the market requires a minimum threshold of dignified subsistence, while the maximum limit is more difficult to locate in terms of theory. There is no incompatibility between equity and efficiency in most cases. Higher wages increase efficiency if the initial level is very low, while wage increases along a career path boost worker motivation and group efficiency. The market mechanism can satisfy the arguments relating to the merit but does not respond to the arguments concerning the need, except instrumentally in terms of merit. However, the need without merit is the central characteristic of those whose lives depend on others, as in the case of children in relation to their parents or the elderly who are not self-sufficient. The modern Welfare state is a social institution that reflects the reciprocal obligations of equity, from individual family units, all the way to the national, European, and humanity ‘family’. In the European experience, the Welfare is a central institution that reflects reciprocal social obligations and has proven to function effectively in times of crisis, supporting the weakest categories.

Period-Cohort Effects Models for Sexual Debut in Namibia

Early sexual debut is often associated with a number of social challenges. However, the hazard and risk factors of changing pattern of age at first sex have not been fully explained. This paper investigated the period-cohort effects by fitting flexible time-to-event models of sexual debut using retrospective cross-sectional data of the 2000 and 2006-7 Namibian Health and Demographic Survey, to establish individual and structural effects, and simultaneously investigated spatial frailty effects, non-linear effects of age, cohort and period on the timing of sexual debut among women. The hazard of sexual debut reduced as the woman’s year of birth increased suggesting a generational effect. The North Eastern parts of Namibia were associated with a higher risk of early sexual debut compared to all other regions. Intervention strategies should be multifaceted and involve not only schools and communities but individual family units as they have a bigger role to play in this regard

Improving population estimates of Glossy Black-Cockatoos (Calyptorhynchus lathami) using photo-identification

Site-based population estimates of the threatened Glossy Black-Cockatoo (‘GBC’; Calyptorhynchus lathami) are often calculated based on age and sex details from transect counts. However, these estimates do not distinguish individual birds, which may result in over-or under-estimation of the population. Two methods were used to estimate GBC populations in Mugii Murum-ban State Conservation Area, New South Wales: (1) the traditional transect method, and (2) a photographic method, which used plumage patterns (primarily the yellow facial feathers of females) and other supporting features to discriminate between foraging GBC family units. The second method has been used previously on Kangaroo Island, South Australia. A catalogue with a matrix of discriminating features was established based on the photographic method; this resulted in a higher population estimate than the transect method in two seasons (winter and spring), as well as providing an annual population estimate, and information on breeding dynamics and local movement of individual family units between foraging habitat. Recommendations for the application of the photographic method are provided. The method provides benefits at both the local scale (with more accurate site population estimates and information on population dynamics) and, with widespread adoption and national cataloguing, valuable knowledge on regional movement patterns and distribution.

Seen and Heard in Mexico: Children and Revolutionary Cultural Nationalism

Increasing interest in US immigration policies — particularly as they affect undocumented youth and Generation 1.5 students — has drawn parallel interest in questions of national identity. Who, for instance, counts as American today, and whom are we responsible for educating? These questions drive research projects and policy debates from disciplines as wide reaching as education, international studies, anthropology, and applied linguistics. However, despite this interest, relatively little attention has yet been given to the experiences of Mexican youth in Mexico — or their particular role in the development of a national identity within their home country.Elena Jackson Albarrán's new book, Seen and Heard in Mexico: Children and Revolutionary Cultural Nationalism, addresses this gap by exploring the surprisingly strong role that children played in the development of a Mexican national identity during the decades immediately following the revolution. Far from being inconsequential bystanders, Albarrán argues, children played a key role in the institutionalization of a cultural consciousness that would prove to be crucial to the ongoing coherence and stability of the Mexican state in the twentieth and twenty-first centuries. In fact, the 1930s and 1940s signify a period of major transition in the social space that children inhabited. Rather than remaining bound to individual family units, children after the revolution became more visibly aligned with schools, community, and the nation. That is, they became civic beings rather than junior family members.This transition, Albarrán explains through a variety of fascinating examples, was not accidental. Rather, the developing state itself set out rather intentionally to develop a number of programs that would directly involve children in the solidification and circulation of ideas related to the newly forming civic and cultural identity of the newly independent Mexican state. Treated deeply and thoroughly chapter by chapter, projects from radio programming and arts curricula to puppet theater and peer literacy initiatives demonstrate both grassroots and top-down interests in involving children in civic roles in the arts and education. These programs, Albarrán emphasizes, constitute the foundations of an effort to build a national identity following the revolution and signify a shift in the identity and social role of children themselves.By highlighting both the historical experiences of Mexican children from two generations ago and the specific nature of the way that a national identity was developed in Mexico during the early part of the twentieth century, Albarrán's book makes significant contributions to historical analyses of the formation of the Mexican state as well as to more contemporary considerations of the experiences of young Mexican nationals in both Mexico and the United States. While the latter application of ideas may move beyond her original historical research purpose, I do believe that her arguments about the new role that Mexican children have played during the mid- and late twentieth century have important implications for how researchers and education policymakers may consider the experiences of Mexican students in US schools, for instance. Within the bounds of her own discipline, Albarrán is clear and focused in her goal to identify and illustrate the foundational contributions that children made to the development of the Mexican nation as we know it today.The book's research itself is impressively thorough. Albarrán treats a wide array of archival sources, the vast majority of them located in Mexico — particularly in Mexico City — as well as published sources in and beyond the field of history. While of high quality as a historical study, this extremely clear and well-written book remains accessible and significant for scholars and students in a wide array of academic disciplines. Albarrán's topic is timely — even more so that she chooses to identify this timeliness in the book itself — and the information that she presents is engaging and redefining. I highly suspect that this excellent book will inform many future studies related to Mexican history and identity, education, immigration, and international relations.

Women, Gender, and the Palace Households in Ottoman Tunisia by Amy Aisen Kallander

248 BOOK REVIEWS / COMPTES RENDUS sultan and placed among the nobility. Usually taken at early age from ten years and over, female slaves particularly were either married to abid al-Bukhari or placed under wealthy aristocratic families for apprenticeship and future employment in the sultan’s palace. While chapter 5 reveals the various roles of slave women in Moroccan society, chapter 6 highlights the changing roles of the abid al-Bukhari and their demographic impact on the black population in Morocco. In chapter 7, El Hamel examines the protracted process of the abolition of slavery and the slave trade that followed Morocco’s ’s reluctance to succumb to European abolitionist pressure that prevailed in North Africa. The final chapter establishes links between Gnawa, referring to slaves who originated from various West African zones during the era of the slave trade, and Gnawa music, which illustrates the extent to which enslaved West Africans culturally enriched Moroccan society. Overall, this book has done well in engaging both the rich array of Arabic and European primary sources and the local Maghribi scholarship that adheres to a classic view of slavery in the Muslim context as benign and free of racial stereotypes and discrimination. The book is well written and insightful in its analysis. In terms of organization, the chapters would have aligned more evenly and neatly by dividing the book into three parts instead of two. That said, El Hamel has written a useful and important work that is bound to stimulate more research on slavery and its legacy not only in Morocco and the Maghreb region but also in the broader Muslim context. Scholars and students of slavery and the African diaspora elsewhere will find this book highly useful for its comparative value. ISMAEL M. MONTANA Northern Illinois University KALLANDER, AMY AISEN. WOMEN, GENDER, AND THE PALACE HOUSEHOLDS IN OTTOMAN TUNISIA. UNIVERSITY OF TEXAS PRESS, AUSTIN 2013 In her 2013 book Women, Gender, and the Palace Households in Ottoman Tunisia Amy Kallander, an American historian focusing on gender issues in the Middle East, examines family life in the beylical palace in Bardo, mainly in the 18th and 19th centuries. Her book is based on broad archival research in Tunisia and France, and Kallander’s carefully scrutinised source material consists of account books, diplomatic correspondence and accounts by European diplomats and travellers, which she supports with a number of maps, reproductions of drawings and colonial postcards, her own photographs of the palace in Bardo, and tables and statistics. The supplementary information in the book is excellent BOOK REVIEWS / COMPTES RENDUS 249 and consists of a short chronology of the important dates, a glossary, index, and three appendices which greatly facilitate the reading process, especially the one presenting the genealogy of the families covered in the book. In this study of the social history of an elite family, Kallander covers a wide range of topics, ranging from Orientalism and marriage politics to the history of food, and she refreshingly points out the many similarities between palace life in Tunisia and the European monarchies. Among other things, she provides detailed descriptions of how the Tunisian beys and their families lived; in what quarters and with whom they lived; how they organised their days and financed their lives; how they travelled, married, and entertained – and, most importantly, what their political influence was in Ottoman Tunisia. According to Kallander, during that period Bardo housed around 1500 inhabitants belonging to the family and entourage of the bey, with the whole household comprising 4000 people at its peak. She observes that the 1500 members of the beylical family lived separately, divided into individual family units. Through the many details that she provides, Kallander paints a stimulating and convincing picture of court culture under the Husaynid family. In addition to palace life, Kallander also analyses the question of female agency, i.e. the various ways in which women belonging to the palace could attain and sustain different forms of power, as well as the European reaction to their influence. Kallander’s book historicises the pre-colonial and colonial obsession with women’s status, which, she claims, during the 19th century became “increasingly a barometer by which foreigners judged Tunisian civilization...

Defence, identity, and urban form: the extreme case of Gjirokastra

Gjirokastra, a century-old small city in southern Albania (now a UNESCO World Heritage site), provides an outstanding example of a Classical and Late Ottoman urban centre. At the same time, it is a special example of urban and architectural design based on self-defence by individual family units. Through an excursion of Gjirokastra's residential neighbourhoods, this article discusses how defence concerns guided its urban morphology and building typology until the collapse of the Ottoman Empire. The idea of war, feuds, and fear has pervaded the residents' self-identity for centuries. The military character of their houses owes much to the local ‘warrior’ mentality that prevailed in times of war and peace.

“알맞게 낳아서 훌륭하게 기르자!” (Let’s Have the Proper Number of Children and Raise Them Well!): Family Planning and Nation-Building in South Korea, 1961–1968

This paper looks at the formation of a South Korean national health network by focusing on the introduction of an ambitious National Family Planning (FP) Program under President Park Chung Hee (1961–1968). The program, influenced in part by the model of its neighbor, Taiwan (Taichung), saw two pilot studies carried out in Koyang (rural, beginning in 1963) and Sundong-gu (Seoul metropolitan area, 1964–1966), before being carried to rural areas nationwide. If the program began with numerous echoes of Japanese colonial practice, it was mobilized specifically in terms of the emerging “modern” South Korean story and the state’s relationship to the welfare of the individual family unit. Using a range of Korean and English-language sources, the paper illustrates how the FP effort took: (1) the Koyang study of the effects of mass communication in rural areas as a tentative blueprint for expanding its national agenda; (2) subsequently enlisted mobile transportation (1966) to expand the scope of its reach; and finally, mobilized “Mothers’ Clubs” (1968) to penetrate the very fabric of rural society, making women both the target as well as the primary means of distribution. Ultimately, this strategy of enlisting the active participation of South Korean women on behalf of the program asked rural women in particular to submit their bodies to the state’s scrutiny, even as they formed the core of the distribution network. In this respect, FP anticipated the mass mobilization of rural South Korea in the New Village movement of the 1970s and leaves behind an ambiguous legacy of state control that is only just beginning to be re-examined.

(Let's Have the Proper Number of Children and Raise Them Well!): Family Planning and Nation-Building in South Korea, 1961–1968

This paper looks at the formation of a South Korean national health network by focusing on the introduction of an ambitious National Family Planning (FP) Program under President Park Chung Hee (1961–1968). The program, influenced in part by the model of its neighbor, Taiwan (Taichung), saw two pilot studies carried out in Koyang (rural, beginning in 1963) and Sundong-gu (Seoul metropolitan area, 1964–1966), before being carried to rural areas nationwide. If the program began with numerous echoes of Japanese colonial practice, it was mobilized specifically in terms of the emerging “modern” South Korean story and the state's relationship to the welfare of the individual family unit. Using a range of Korean and English-language sources, the paper illustrates how the FP effort took: (1) the Koyang study of the effects of mass communication in rural areas as a tentative blueprint for expanding its national agenda; (2) subsequently enlisted mobile transportation (1966) to expand the scope of its reach; and finally, mobilized “Mothers' Clubs” (1968) to penetrate the very fabric of rural society, making women both the target as well as the primary means of distribution. Ultimately, this strategy of enlisting the active participation of South Korean women on behalf of the program asked rural women in particular to submit their bodies to the state's scrutiny, even as they formed the core of the distribution network. In this respect, FP anticipated the mass mobilization of rural South Korea in the New Village movement of the 1970s and leaves behind an ambiguous legacy of state control that is only just beginning to be re-examined.

Twenty years of follow‐up among survivors of childhood and young adult acute myeloid leukemia

Limited data exist on the comprehensive assessment of late medical and social effects experienced by survivors of childhood and young adult acute myeloid leukemia (AML). This analysis included 272 5-year AML survivors who participated in the Childhood Cancer Survivor Study (CCSS). All patients were diagnosed at age < or =21 years between the years 1970 and 1986, and none underwent stem cell transplantation. Rates of survival, relapse, and late outcomes were analyzed. The average follow-up was 20.5 years (range, 5-33 years). The overall survival rate was 97% at 10 years (95% confidence interval [95%CI], 94%-98%) and 94% at 20 years (95% CI, 90%-96%). Six survivors reported 8 recurrences. The cumulative incidence of recurrent AML was 6.6% at 10 years (95% CI, 3.7%-9.6%) and 8.6% at 20 years (95% CI, 5.1%-12.1%). Ten subsequent malignant neoplasms (SMN) were reported, including 4 with a history of radiation therapy, for a 20-year cumulative incidence of 1.7% (95% CI, 0.02%-3.4%). Six cardiac events were reported, for a 20-year cumulative incidence 4.7% (95% CI, 2.1%-7.3%). Half of the survivors reported a chronic medical condition and, compared with siblings, were at increased risk for severe or life-threatening chronic medical conditions (16% vs 5.8%; P < .001). Among those aged > or =25 years, the age-adjusted marriage rates were similar among survivors and the general United States population (57% for both) and lower compared with siblings (67%; P < .01). Survivors' college graduation rates were lower compared with siblings but higher than the general population (40% vs 52% vs 34%, respectively; P < .01). Employment rates were similar between survivors, siblings, and the general population (93%, 97.6%, and 95.8%, respectively). Long-term survival from childhood AML > or =5-years after diagnosis was favorable. Late-occurring medical events remained a concern with socioeconomic achievement lower than expected within the individual family unit, although it was not different from the general United States population.

Dialectical Behavior Therapy for Adolescents With Bipolar Disorder: A 1-Year Open Trial

To describe an adapted version of dialectical behavior therapy for adolescents with bipolar disorder. The dialectical behavior therapy intervention is delivered over 1 year and consists of two modalities: family skills training (conducted with individual family units) and individual therapy. The acute treatment period (6 months) includes 24 weekly sessions; sessions alternate between the two treatment modalities. Continuation treatment consists of 12 additional sessions tapering in frequency through 1 year. We conducted an open pilot trial of the treatment, designed as an adjunct to pharmacological management, to establish feasibility and acceptability of the treatment for this population. Participants included 10 patients (mean age 15.8 +/- 1.5 years, range 14-18) receiving treatment in an outpatient pediatric bipolar specialty clinic. Symptom severity and functioning were assessed quarterly by an independent evaluator. Consumer satisfaction was also assessed posttreatment. Feasibility and acceptability of the intervention were high, with 9 of 10 patients completing treatment, 90% of scheduled sessions attended, and high treatment satisfaction ratings. Patients exhibited significant improvement from pre- to posttreatment in suicidality, nonsuicidal self-injurious behavior, emotional dysregulation, and depressive symptoms. Dialectical behavior therapy may offer promise as an approach to the psychosocial treatment of adolescent bipolar disorder.

Who knows more about the impact of malocclusion on children's quality of life, mothers or fathers?

Shared decision making between children and parents is required in orthodontics. This study compared agreement among mothers, fathers, and children regarding the oral health-related quality of life (OHRQoL) of children. A sample of 71 child patients (41 girls and 30 boys) aged 12.6 years with an orthodontic treatment need, together with both their parents completed components of the child OHRQoL measure. Agreement among children, mothers, and fathers was derived from the 31 analogous questions and assessed using comparison and correlation analyses. Comparison analyses identified significant differences between mother's and children's reports and between father's and children's reports. The magnitude of the difference between mother's and children's reports, and between father's and children's reports could best be described as moderate (standard difference >0.2). In addition, absolute differences in scores constituted between 12 and 18 per cent of domain and overall scores for both mother's and children's, and father's and children's reports. Correlation analysis, at the individual family unit level, showed that agreement between mothers and children, and between fathers and children was fair [intraclass correlation coefficient (ICC) < 0.04]. Neither mothers nor fathers know their child's oral health status very well, as there was significant disagreement between mothers', fathers', and children's perceptions. The disagreement between mothers and children, and fathers and children was similar. While at the group level, mothers and fathers tended to agree on perception of their children's oral health status, at an individual family unit level they did not.

Twenty Years of Follow-Up among Survivors of Childhood and Young Adult Acute Myeloid Leukemia (AML): A Report from the Childhood Cancer Survivor Study (CCSS).

Survival rates for childhood AML continue to improve. Limited data exist on the comprehensive assessment of late medical and social effects experienced by these aggressively treated individuals. This analysis includes 272 5-yr survivors of AML participating in the CCSS diagnosed ≤ age 21, between 1970–1986. AML survivors who received a blood or marrow transplant are excluded from the current analysis. Comparisons among treatment groups and to a sibling control group are age and gender adjusted. Survivors (55% female) were on average 7 yrs old at dx and 28 yrs at follow-up, 56% received chemotherapy only, 34% chemotherapy/RT. Average follow-up was 22.6 yrs (16.1–33.5). Among these 5-yr survivors, overall survival was 97% (95% CI, 94–98%) at 10 yrs and 94% (95% CI, 92–97%) at 20 yrs. Six individuals reported 8 recurrences a mean of 11.1 yrs (5.6–16.6) from diagnosis, 2 died from relapse, 1 from congestive heart failure (CHF), and 1 from a myocardial infarction (MI). All cause standardized mortality ratio was 4.7 (95% CI 2.8–7.5). Cumulative incidence of recurrent AML at 10 and 20 years was 1.8% (95% CI 0.2–3.4%) and 3.7% (95% CI 1.4–5.9%), respectively. Eight survivors reported 10 subsequent malignant neoplasms (SMN) (5 breast cancers, 3 CNS tumors, 1 ovarian tumor, 1 salivary gland tumor) a mean of 18.7 yrs (9.2–26.4) from diagnosis, 3 with a history of RT exposure. SMN cumulative incidence at 20 yrs was 1.6% (95% CI 0.02–3.3%) with a standardized incidence ratio of 3.2 (95% CI 1.4–6.0). Six cardiac events (5 CHF and 1 MI) occurred a mean of 16.4 yrs (12.8–18.4) from diagnosis, 20-yr cumulative incidence 2.4% (95% CI 0.5–4.4%). Among those aged 25 yrs or more, marriage rates were similar among AML survivors and the general U.S. population (59%), but lower compared to siblings (69%) (p<0.01). College graduation rates were lower among survivors compared to siblings, but higher than in the general population (42% vs. 52% vs. 34%, respectively, p<0.01). No significant difference in graduation rates was found among those treated with or without CNS directed RT (p=0.9). All survivors and siblings were employed (100%) and most had health insurance (93% vs. 90%). Long-term survival from childhood AML greater than 5 yrs from diagnosis is favorable. Late occurring medical events remain concerning. Marriage and education rates may be lower than expected within individual family units; yet not significantly different from the U.S. population.

‘Corralling the Virus’: Migratory Sexualities and the ‘Spread of AIDS’ in the US Media

In this paper I examine the emergence of a popular geography of AIDS in the US mass media in the 1980s, exploring the role of global mobility in the construction of AIDS as a national threat. Efforts to map the geography of the epidemic served to reinforce the illusion that the borders of the nation might effectively be defended against the incursions of HIV via the bodies of those marked as outside the proper citizenry. The representation of Africa as the ‘cradle of AIDS’, the images of crack houses in narratives about urban AIDS in the United States, and stories of White gay men ‘going home to die’ in the ‘heartland’ constructed a geography of danger linking race, sexuality, and ‘home’ that promised security for those within particular borders. Emphasizing the power of racialized maternal compassion as a model for the national response to AIDS, these stories described normative heterosexual domesticity as a means of fixing sexuality in place. This geography proposed that individual family units might reinforce national borders which seemed increasingly fluid in the context of global flows of populations, a construction that illustrates the intersection of space and sexuality in the representation of an emerging global health crisis and produces spatializations of danger that continue to shape the construction of ‘global AIDS’.

Family Business and Multiple Levels of Conflict

Family businesses are fertile fields for conflict. The influence of the founding families on the basic tenets and culture of the company may be unparalleled in business. When attempts are made to modify the family business as it progresses to another stage of development, conflict may arise. Due to the verlay of the company culture and individual family units, the means to resolve conflict becomes a very intricate process. This article examines a means to predict conflict relative to the phases of development of a family business. In addition, multiple levels of conflict are examined as well as the appropriate resolution process for the differing levels of conflict.