Browsing by Subject "Family"
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Item Does a Positive Family History of Glaucoma Foretell Severity?(2014-02-04) Vu, Khiem; Markel, Nathan; Parikh, Kisan; Adams-Huet, Beverley; Li, Xilong; Kooner, KaranjitPURPOSE/RELEVANCE: There is a threefold increase in the risk of primary open-angle glaucoma (POAG) in individuals with positive family history. We wished to see if the family history also led to a more severe form of the disease. METHODS: In an IRB-approved retrospective chart study at a university-affiliated medical center, data was collected from 224 patients diagnosed with glaucoma. Positive family history was defined by first, second, or third degree relatives affected (FHx-pos). Patients with negative family history were referred to as controls. Patients with unknown family history were excluded. Age, gender, race, BMI, cup/disk ratio (C/D), visual field defects, intraocular pressure (IOP), central corneal thickness (CCT), and current glaucoma medications were recorded. FHx-pos and control groups were compared using Fisher's Exact and Wilcoxon Rank sum tests for categorical and continuous variables, respectively. RESULTS: Among patients with glaucoma, there were 82, 120, and 22 patients with positive, negative, and unknown family history, respectively. The FHx-pos group was 47.6% white, 39% black, and 13.4% Hispanic, while the control group was 40.8% white, 40.8% black, and 18.4% Hispanic; no clinically significant differences were noted. Both groups were similar in age (63.3±14.8 vs. 64.9±11.8 years, p=0.5) and CCT (539 vs. 540 μm, p=0.8). The FHx-pos group was predominantly female (70.7% vs. 45%, p<0.001), had elevated IOPs (16.9±4.0 vs. 15.7±4.2 mm Hg, p=0.040), and were prescribed more glaucoma medications (98.9 vs. 92.5%, p=0.05). The mean C/D for both groups was approximately 0.73 (p=0.86) with the FHx-pos group having slightly more optic cupping (29.6 vs. 26.1% of patients, defined as C/D > 0.9; p=0.6). DISCUSSION: The results suggest that glaucoma patients with affected relatives tend to be female. Sex-specific genetic factors or expression may contribute to disease progression, but a full mechanism has yet to be completely delineated. The FHx-pos group also had higher IOP, required more medications, and experienced slightly more optic nerve cupping, all of which indicate a more severe form of the disease. CONCLUSION: The results of this study corroborate the importance of taking a family history of glaucoma. This is especially important for females, for whom aggressive treatment may be necessary. The gender finding merits further study into the possible heritability of predisposing factors in the pathogenesis of POAG in female populations. REFERENCES: Fingert JH. Primary open-angle glaucoma genes. Eye. 2011; 25, 587-595Item Factors Associated with Posttraumatic Growth in Trauma Patients and ICU Family Members(2017-07-10) Roden-Foreman, Kenleigh; Robinson, Richard C.; Warren, Ann Marie; Roaten, Kimberly Dayle; Bennett, Monica; Petrey, LauraEach year in the United States, over three million people are hospitalized for traumatic injuries and five million are admitted to intensive care units (ICUs) as a result of traumatic injury or critical illness. Although the traditional benchmark for successful care in these settings has been patient survival, there has been an increased awareness of psychosocial issues that continue to impact patients' and family members' quality of life beyond the hospital stay. The experience of a traumatic injury or serious illness, for patients or their families, can be challenging to recover from both physically and psychologically. Extensive literature shows that presence of a psychological disorder can lead to or exacerbate negative physical health outcomes in patients, including increased risk of re-hospitalization, greater healthcare costs, and poorer quality of life. From the perspective of family members, psychological strain may hinder carrying out necessary caregiving activities for the patient, and this strain may continue unchecked since the majority of support and resources are directed at patients, not their caregivers. The primary emphasis of psychology, medicine, and related disciplines tends to be on ways in which traumatic events are precursors to distress and, potentially, severe psychological and physical dysfunction. Although this focus is understandable given the prevalence of research and clinical training on the topic, substantially less literature describes the influence of positive psychological outcomes. Posttraumatic growth (PTG) describes positive change resulting from a struggle with highly challenging events, such as sustaining a traumatic injury or witnessing a family member in the ICU. To date, no studies have examined factors associated with PTG in a heterogeneous sample of trauma patients or in the families of trauma/critical care ICU patients. The present studies sought to fill these gaps in the literature. The first study determined factors associated with PTG in a mixed trauma patient population one year post-injury. The second study did the same, but examined PTG in family members of trauma/critical care ICU patients one year post-hospitalization. By identifying variables related to growth, clinical interventions may be targeted to bolster those areas in hopes of improving outcomes in patients and their family members.Item Families in the ICU(2020-10-16) DeLisle, SylvainItem The Impact of Specialized Family Camps on Quality of Life and Hope in Families Who Are Coping with Pediatric Cancer(2012-08-15) Cook, Ellen Claire; Wetherington, Crista E.; Germann, Julie; Chiu, Chung-Yi; Leavey, PatrickBACKGROUND: Over the past several decades, specialized summer camps for children with cancer have been shown to have various positive results in those who attend. Family camps have become increasingly popular over the past few years, but the efficacy of family camps for specialized populations has not been well established through research. In addition, few studies have addressed the benefits of the camp experience over time, especially in regard to its impact on quality of life. The aim of this study was to learn whether or not the family camp experience increases the quality of life of families with a child with cancer, and whether or not these changes are maintained after the camp experience ends. In addition, this study examined the impact of camp on levels of hope, and analyzed how hope and social support contribute to the quality of life of those who attend camp. SUBJECTS: A total of 66 families participated in this study. Participants include parents, cancer patients or survivors, and siblings. Thirty-nine families who attended a specialized weekend camp participated in the study, and a control sample of 27 families who did not attend camp was recruited as well. METHOD: Questionnaire data was collected at three time points: pre-camp, post-camp, and a three-month follow up. Measures included a demographic questionnaire, age appropriate versions of the PedsQLTM 4.0 Generic Core Scales, the PedsQLTM 2.0 PedsQLTM 2.0 Family Impact Module, the Hope Scale (Adult and Child versions), the Young Children’s Hope Scale, and a brief follow-up questionnaire. RESULTS: Quality of life did not significantly increase in the camp group in the overall family unit. However, quality of life was shown to be significantly higher in the camp group than the control group at the beginning and end of camp. Siblings demonstrated a significant increase in quality of life when examined separately from the family unit. No significant changes in hope or differences in hope between groups were observed. DISCUSSION: Though this study did not demonstrate the efficacy of family camp as predicted, it did show that individual family members are impacted by camp in different ways. Camp has been show to benefit siblings in particular, which is indicated by improvement in quality of life, hope, and social support in this population. This study also shows that different results may be found using different measures of the same variables.Item Influences on Mental Health Service Utilization for Vietnamese Young Adults(2012-08-15) Phan, Hang Tu; Stewart, Sunita M.; Lee, Simon Craddock; Chiu, Chung-YiBACKGROUND: Vietnamese-Americans underutilize mental health services. Several factors have been proposed to influence rates of service utilization within this population, including cultural identification and families' acceptance of such services. Most measures of cultural identification are lengthy and burdensome. Furthermore, studies examining the link between parental attitudes towards mental health services and their children's attitudes have only included children who were under the age of 18 - therefore unable to legally seek their own services. This study was designed to address these gaps by developing and testing brief scales of identification with Vietnamese and American culture, and obtaining information about the influence of parents' attitudes on older adolescents and young adults in this cultural group where a strong family orientation persists through the lifespan. A third aim of the study was to examine the role of the participants' acceptance of mental health services both as a predictor for utilization of such services, and as a mediator between other predictors and utilization. SUBJECTS: The participants in the study included a total of 87 Vietnamese-American young adults between the ages of 18 to 30 years old. Participants were recruited from the Texas Exes Asian Alumni Network (TEAAN) in Austin, Texas and from the Mother of Perpetual Faith Catholic Church's youth group. Recruitment also occurred through a method called the "snowball effect," where those involved in the study were asked to help recruit additional participants. METHOD: Surveys were completed on-line. Participants reported their mental health service utilization in the past 12 months. They also were administered measures of potential predictors: cultural identification scales, the participants' distress level, perceived stigma towards mental health services, perceived parental acceptance of mental health services, and their own (personal) acceptance of mental health services. RESULTS: The psychometric properties of the brief cultural identification scales were examined; the scales have good validity, but slightly low reliability. None of the proposed factors were found to be significant predictors of formal mental health service utilization, but items assessing distress level were found to correlate with service utilization at a trend level. The only factor found to predict personal acceptance was perceived parental acceptance of these services. Because personal acceptance was not found to be a predictor of mental health service use, it could not serve as a mediating variable between the other factors and service utilization. DISCUSSION: Before the originally developed cultural identity scales can be used for research, further development of the scales will be necessary. A limitation of this study is that there were very few participants who reported formal mental health service utilization, reducing the power to determine prediction to this variable. In this sample, only distress was found to be even a marginal predictor of mental health service use, suggesting that the low rates of mental health service utilization found in these Vietnamese young adults may in fact be due to actual low levels of psychological distress. The fact that parental acceptance significantly predicted personal acceptance of mental health services among participants supports the idea that parental attitudes towards mental health services may have been adopted by their children, even after they were independent enough to seek their own services. Future research and clinical implications are discussed.Item [News](1984-05-30) Rutherford, SusanItem [News](1979-07-31) Harrell, AnnItem [News](1985-04-25) Harrell, AnnItem [Southwestern News](1993-11-09) Gentry, LynnItem [Southwestern News](2002-11-14) Harrell, AnnItem [Southwestern News](2000-05-30) Donihoo, RachelItem [Southwestern News](1997-09-23) McNeill, Bridgette RoseItem [UT Southwestern Medical Center News](2009-02-24) Donihoo, RachelItem [UT Southwestern Medical Center News](2010-03-23) Donihoo, RachelItem [UT Southwestern Medical Center News](2006-10-24) Donihoo, RachelItem [UT Southwestern Medical Center News](2008-09-26) Donihoo, RachelItem [UT Southwestern Medical Center News](2011-09-01) Bolles, DebbieItem [UT Southwestern Medical Center News](2010-06-28) Shear, Kristen Holland