Live-in Partner Research Articles

Developing a scale for measuring expectancy of retaining natural teeth for life and comparison of results obtained using a global item and a multi-item scale of measurement

Objective. To develop and test a scale for measuring expectancy of retaining teeth for life and to compare the estimates when using a global item with those obtained with a multi-item scale of measurement. Material and Methods. The design of the study was cross-sectional selected and random sample surveys using a self-administered questionnaire or interview. There were two groups of patients and a national sample aged 16–79 years (n=1,274); response rate 64%. The main results pertain to dentate subjects in a global group (n=615) and in a scale group (n=609). The outcome measure was expectancy of retaining natural teeth for life. Results. When using the global item, 92% (95% CL 89.8, 94.1) of the respondents believed they would definitely or possibly retain their natural teeth for life, significantly higher than the 81% (95% CL 77.6, 84.0) obtained with the 4-item conditional scale. Cronbach's alpha was 0.89 for the 4-item scale and the test–retest reliability moderate (kappa=0.51; 0.77 for ±1). The adults’ belief in retaining teeth for life was significantly associated with having a live-in partner (p=0.009) when the global question was the dependent variable; and sex (p=0.000) and education (p=0.004) when the 4-item scale was the dependent variable. Explained variance was 3.8% and 4.5%, respectively. Conclusions. The internal reliability of the 4-item scale was high. A significantly lower proportion of people reported belief in retaining natural teeth for life when employing the 4-item conditional scale than when the unconditional global question was used.

Socio-demographic variables influence outcome in Radiation Therapy Oncology Group head and neck trials

6043 Background: The specific aim of this study was to evaluate the influence of socio-demographic factors on local-regional (LR) control and survival of patients treated on RTOG head and neck cancer clinical trials. Methods:Patients treated on RTOG 9003, RTOG 9111 and RTOG 9703 were utilized. The model was stratified by protocol and a step-up procedure using a 0.05 significance level was initially used to build the model. The Cox proportional hazards model was used to determine if any tumor or socio-demographic variables (age, gender, race, Karnofsky Performance Status (KPS), T-stage, N-stage, marital status, number of persons in household, education level, household income prior to cancer diagnosis, and tobacco use) are independent prognostic variables for LR control and/or survival. Results:A total of 1901 patients were entered onto the 3 RTOG trials of which 1822 were analyzable. Fifty-nine percent of the analyzable patients were from 9003, 28% from 9111 and 13% from 9703. In multivariate analyses T and N-Stage, and KPS were significant for both survival and LR control. Variables found to have prognostic value independent of disease related variables were gender, age, marital status and income for survival and marital status and race for LR control. A significant interaction between marital status and gender existed for both endpoints. Male patients currently married or a live-in partner, did significantly better than the other male patients, while no such effect was seen in the female patients. Tobacco use at protocol entry was evaluated in the multivariate model with only RTOG 9003 and 9111, and was significant for both endpoints. Conclusions: The socio-demographic variables race and marital status were found to have independent prognostic value for predicting LR control. Income and marital status were found to have independent prognostic value for predicting survival. These variables may identify patients requiring additional support and early interventions during the course of treatment to improve outcome. No significant financial relationships to disclose.

Socio-demographic variables influence outcome in Radiation Therapy Oncology Group head and neck trials

6043 Background: The specific aim of this study was to evaluate the influence of socio-demographic factors on local-regional (LR) control and survival of patients treated on RTOG head and neck cancer clinical trials. Methods:Patients treated on RTOG 9003, RTOG 9111 and RTOG 9703 were utilized. The model was stratified by protocol and a step-up procedure using a 0.05 significance level was initially used to build the model. The Cox proportional hazards model was used to determine if any tumor or socio-demographic variables (age, gender, race, Karnofsky Performance Status (KPS), T-stage, N-stage, marital status, number of persons in household, education level, household income prior to cancer diagnosis, and tobacco use) are independent prognostic variables for LR control and/or survival. Results:A total of 1901 patients were entered onto the 3 RTOG trials of which 1822 were analyzable. Fifty-nine percent of the analyzable patients were from 9003, 28% from 9111 and 13% from 9703. In multivariate analyses T and N-Stage, and KPS were significant for both survival and LR control. Variables found to have prognostic value independent of disease related variables were gender, age, marital status and income for survival and marital status and race for LR control. A significant interaction between marital status and gender existed for both endpoints. Male patients currently married or a live-in partner, did significantly better than the other male patients, while no such effect was seen in the female patients. Tobacco use at protocol entry was evaluated in the multivariate model with only RTOG 9003 and 9111, and was significant for both endpoints. Conclusions: The socio-demographic variables race and marital status were found to have independent prognostic value for predicting LR control. Income and marital status were found to have independent prognostic value for predicting survival. These variables may identify patients requiring additional support and early interventions during the course of treatment to improve outcome. No significant financial relationships to disclose.

Social Support and Adjustment After Spinal Cord Injury: Influence of Past Peer-Mentoring Experiences and Current Live-In Partner.

Social Support and Adjustment After Spinal Cord Injury: Influence of Past Peer-Mentoring Experiences and Current Live-In Partner.

HIV-1 and HIV-2 Seroprevalence and Risk Factors Among Hospital Outpatients in the Eastern Region of Ghana, West Africa

Summary: A cross-sectional study of 854 outpatients seen at three hospitals in the Eastern Region of Ghana, West Africa assessed HIV-1 and HIV-2 seroprevalence rates and associated risk factors. During mid-1999, patients were tested in an anonymous study linked to a questionnaire and abstracted record data in three distinct communities with differing levels of urbanization. Combined HIV seroprevalence rates were 19.2% for Agomanya, the most rural community, 5.1% for Akwatia, and 3.4% for Nkawkaw, the most urbanized community. HIV-1 infection alone accounted for 84.5% of cases, compared with 9.5% and 6.0% for HIV-2 and dual infection, respectively. In a multivariable model, the Agomanya location was significantly associated with HIV status (odds ratio [OR], 7.7; 95% confidence interval [CI], 2.9-20.1; p < .0001). Employed people were also more likely to be infected (OR, 4.3; 95% CI, 1.02-18.3; p = .047). Among prenatal patients, those from Agomanya were more likely to report no live-in partner or spouse compared with Nkawkaw and Akwatia (p < .0001). These findings suggest sexual partner exchange patterns may be more useful in explaining HIV seroprevalence rates than level of community urbanization. Intervention programs directed at these high risk populations for HIV infection in Ghana are urgently needed.

HIV-1 and HIV-2 seroprevalence and risk factors among hospital outpatients in the Eastern Region of Ghana, West Africa.

A cross-sectional study of 854 outpatients seen at three hospitals in the Eastern Region of Ghana, West Africa assessed HIV-1 and HIV-2 seroprevalence rates and associated risk factors. During mid-1999, patients were tested in an anonymous study linked to a questionnaire and abstracted record data in three distinct communities with differing levels of urbanization. Combined HIV seroprevalence rates were 19.2% for Agomanya, the most rural community, 5.1% for Akwatia, and 3.4% for Nkawkaw, the most urbanized community. HIV-1 infection alone accounted for 84.5% of cases, compared with 9.5% and 6.0% for HIV-2 and dual infection, respectively. In a multivariable model, the Agomanya location was significantly associated with HIV status (odds ratio [OR], 7.7; 95% confidence interval [CI], 2.9-20.1; p <.0001). Employed people were also more likely to be infected (OR, 4.3; 95% CI, 1.02-18.3; p =.047). Among prenatal patients, those from Agomanya were more likely to report no live-in partner or spouse compared with Nkawkaw and Akwatia (p <.0001). These findings suggest sexual partner exchange patterns may be more useful in explaining HIV seroprevalence rates than level of community urbanization. Intervention programs directed at these high risk populations for HIV infection in Ghana are urgently needed.

The Detection and Treatment of Psychiatric Disorders and Substance Use Among Pregnant Women Cared for in Obstetrics

A recent report from California suggests that psychiatric disorders and substance use are significantly underrecorded on hospital delivery records and that these disorders correlate with inadequate prenatal care. Clinicalstudies have validated a primary care screening instrument for psychiatric disorders, the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire. Both maternal psychiatric and substance use problems have the potential to adversely affect mothers and their infants. The present study used the PRIME-MD instrument to assess current psychiatric disorders in 186 women older than 18 years who were under prenatal care at a university-based obstetrics clinic. Antenatal alcohol and drug use was explored using the Alcohol and Drug CAGE questionnaires. Seventy of the women, 38% of the total, screened positive for psychiatric disorder and/or substance use. They were significantly likelier than screen-negative women to report an unexpected pregnancy and to have a history of psychiatric treatment. Educational level, racial background, living with a partner or not, working outside the home, and age could not be related to the risk of a positive screen. Screen-positive women were likelier to receive inadequate or intermediate prenatal care and were more often referred to child protective services, but these associations were not significant. No important differences in obstetrical history or outcomes could be identified. More than half of the screen-positive women had depressive and anxiety symptoms, but relatively few had agitation, behavioral symptoms, or sleep disorder. The likelihood of having mental health evaluated was not a function of age, race, or obstetrical outcome. Treatment for psychiatric disorder or substance use, recorded in 15 of the 70 screen-positive women, was associated with lack of a live-in partner, referral to a child protective service during the index pregnancy, and more spontaneous abortions. The investigators conclude that a substantial number of obstetrical patients have a are psychiatric disorder or substance use problem that goes unrecognized unless screening efforts are undertaken. In view of the potential adverse effects on both maternal and infant outcomes, further work is needed to develop effective interventions.

Abuse of women and children in a Philippine community

This retrospective study describes the demographic profiles, types of injuries and characteristics of abusers of 1354 women and children survivors of domestic violence who sought medical care from the obstetrics and gynecology resident and attending staff in the Women and Children Protection Unit in Vicente Sotto Memorial Medical Center from 1 January 1997 to 31 December 1998. Thirty-nine percent of these patients were sexually abused; their peak age was 11–20 years. Almost 75% of sexual abusers were from outside of the household. The highest incidence of physical abuse occurred in ages 26–35 years. Seventy-five percent of this form of abuse was in the home and perpetrated by husbands and live-in partners. Our data add to the expanding literature demonstrating the existence of family violence throughout the world. The role of our Protection Unit in responding to the victims of family violence is in keeping with the responsibilities and the ethical obligations all obstetrician–gynecologists have to the safety, physical and psychological needs of the women they serve.

Social relationships and intravenous drug use among methadone maintenance patients

This study examined the extent to which social relationships were associated with continued injection drug use and needle sharing among 252 methadone maintenance patients. Logistic regression analyses indicated that drug use was highest among persons who had a substance using live-in partner and among those with more drug-using social relationships. Among injectors, whites and those who had more people present during IV drug use were more likely to share needles, while those with more emotional support were less likely to do so. These findings suggest that personal relationships strongly influence continued injection drug use and that methadone programs should help patients develop social networks of non-users.

The relationship between quality of interpersonal relationships and major depressive disorder: findings from the National Comorbidity Survey

Background: The current study compared the quality of interpersonal relationships in individuals with major depressive disorder to individuals with dysthymia, comorbid depression, nonaffective disorders, and no psychiatric disorders. Methods: Using data from the National Comorbidity Study, a series of logistic regressions, controlling for demographic variables, were conducted to examine the strength of the association between a major depressive disorder and interpersonal dysfunction (positive and negative interactions) in contrast to other psychiatric disorders. Results: Respondents with current major depressive disorder reported significantly fewer positive interactions and more negative interactions with their spouse or live-in partner than those with nonaffective disorders, and than those with no psychiatric disorders. There were no significant differences in quality of interpersonal relationships between respondents with major depressive disorder and those with dysthymia. Among those with major depressive disorder, comorbidity or treatment-seeking behavior did not significantly contribute to degree of interpersonal difficulties. The strength of the association between interpersonal dysfunction and depression were, in general, comparable for men and women with major depressive disorder. Limitations: The cross-sectional design of this report precludes inferences regarding causality between quality of interpersonal relationship and current major depressive disorder. Conclusions: The results of this study indicate that, relative to psychiatric illness in general, poor intimate relationships are characteristic of a current major depressive disorder.

Smoking in pregnancy in Nottingham - 11 years on

The aim of this study was to assess whether the smoking habits of women during pregnancy had changed since the baseline survey conducted in 1986 in Nottingham (Madeley et al, 1989). The study design involved a quantitative survey of all pregnant women attending the two hospital antenatal clinics in Nottingham over a six week period in 1997. A total of 1716 self-completion questionnaires were returned, representing a response rate of 80%. It was found that although the percentage of women smoking in pregnancy had fallen from 31% in 1986 to 24% in 1997, there were still similar factors associated with prevalence of smoking in pregnancy. For example, the largest proportion of smokers by age group was in the 14–20 age range but this had increased from 47% in 1986 to 56% in 1997. The study concluded that although there had been an increase in the percentage of women receiving advice about smoking and pregnancy from midwives and nurses, there are some worsening trends in the prevalence of smoking in pregnancy, particularly in the teenage population. It is therefore recommended that smoking intervention strategies are specifically targeted towards young, disadvantaged women and those with no live-in partner and those in their household.

Response Effects Due to Bystander Presence in CASI and Paper-and-Pencil Surveys of Drug Use and Alcohol Use

In this study we investigated the influence of bystanders on self-administered interviews asking about the use of alcohol and illicit drugs. Interview participants were adolescents and young adults living in urban and suburban areas of the United States. Participants were assigned randomly to either a computerized or a paper-and-pencil self-administered interview. Results show that the impact of bystanders during the interview varies according to the identity of the bystander, age of the person interviewed, and the mode of interview. When a parent was present during the interview, survey participants were less likely to report the use of alcohol and marijuana. The influence of parents was stronger for adolescents than for young adults. The use of computer-assisted self-administered interviewing, compared to interviews with paper-and-pencil forms, reduced the effects due to the presence of parents during the interview. The presence of siblings during the interview had a small, negative effect on reports of using alcohol or illicit drugs. Among married or cohabiting respondents, the presence of the husband, wife, or live-in partner had no influence on reports of alcohol use or drug use. [Translations are provided in the International s Section of this issue.]

Prevalence of abuse of women with physical disabilities

Objective: Emotional, physical, and sexual abuse of women with physical disabilities is a problem largely unrecognized by rehabilitation service providers. This article documents the prevalence of abuse of women with physical disabilities compared to women without physical disabilities. Design: Case-comparison study using written survey. Data were analyzed using χ 2 analyses and the Mann-Whitney U Wilcoxon rank sum W tests. Setting: General community. Participants: A sample of 860 women, 439 with physical disabilities and 421 without physical disabilities, was compiled from women responding to a national sexuality survey. Main Outcome Measures: The women were asked if they had ever experienced emotional, physical, or sexual abuse. If they answered yes, they were asked to identify the perpetrator(s) of the abuse and when the abuse began and ended. Results: Sixty-two percent of both groups of women had experienced some type of abuse at some point in their lives. Of women who had experienced abuse, half of each group had experienced physical or sexual abuse. Husbands or live-in partners were the most common perpetrators of emotional or physical abuse for both groups. Male strangers were the most common perpetrators of sexual abuse for both groups. Women with physical disabilities also were more likely to be abused by their attendants and by health care providers. Thirteen percent of women with physical disabilities described experiencing physical or sexual abuse in the past year. Conclusions: Women with physical disabilities appear to be at risk for emotional, physical, and sexual abuse to the same extent as women without physical disabilities. Prevalence of abuse by husbands or live-in partners in this study is similar to estimates of lifetime occurrence of domestic violence for women living in the United States. Women with physical disabilities are more at risk for abuse by attendants or health care providers. They are also more likely to experience a longer duration of abuse than women without physical disabilities.

Women living with HIV: sexual behaviors and counseling experiences.

Seventy-two ethnically diverse women attending two outpatient HIV clinics in Los Angeles self-administered questionnaires. Nineteen women (26%) reported sexual activity in the two months prior to the survey; most were sexually monogamous and emotionally involved with live-in male partners. According to self-reports, 13 women (18% of the total sample and 68% of those who were sexually active) had engaged in at least one form of risky sexual activity. The majority (81%) of sexual partners were aware of the respondent's HIV infection, but most (67%) were seronegative. Post-test counseling was reportedly noncomprehensive (e.g., 47% of the respondents did not recall receiving information about using condoms correctly). Few women accessed HIV support services. Results underscore the need for more effective counseling and support interventions for this population.

Why sexual abuse? An exploration of the intergenerational hypothesis

The issue of sexual abuse in the family backgrounds of offenders and mothers of victims is explored in a clinical sample of 154 cases of intrafamilial sexual abuse. More than a third of the offenders and about half of the mothers had experienced or been exposed to sexual abuse as children. Cases were divided into those where the sexual abuser was the biological father in an intact family, those where he was a stepfather or mother's live-in partner, and those where he was a noncustodial father. In biological father cases, parents were about equally likely to have experienced sexual abuse during childhood, in the stepfather/live-in partner cases, the mother was more likely to have had such an experience, and in the noncustodial father cases, the offender was more likely to have come from a sexually abusive family.

The Myth of the “Collusive Mother”

Mothers whose children were sexually victimized by three types of father figures are compared on factors related to the concept of maternal collusion. Categories of mothers are those whose children were abused by bio-fathers married to the mothers, by stepfathers and mothers' live-in partners, and by noncustodial fathers where there is a separation or divorce. Variables related to collusion that were explored are maternal protectiveness when made aware of the sexual abuse, mothers' relationship with the victim, and maternal dependency. Mothers who were separated or divorced from the offender were rated the most positively on all three variables. Mothers in the other two groups were rated about equally, but findings do not support a conclusion that they are collusive in the sexual abuse of their children.

An annual rhythm in the battering of women.

Over 27,000 reports about women abused by their live-in male partners were provided by 23 shelter organizations in five locations in the United States. Cosinor analyses revealed statistically significant annual rhythms in the frequencies of abuse, with maxima in the summer. The rhythms were closely related to annual changes in ambient temperature in these locations, and the time of the maxima was similar to those previously reported for assaults and rapes. The findings support the hypothesis that violence by men toward women increases in summer independently of any major seasonal changes in the opportunity for contact between perpetrator and victim.