The hypothesis of a genetic component in the etiology of migraine is getting a foothold. However, to explore genetic associations, precision in clinical phenotypization is crucial. For this reason, migraine-specific questionnaires, well discriminating between primary headaches, are required when large numbers of individuals need to be assessed.
We adapted and translated in two languages, German and Italian, the Finnish Migraine-Specific Questionnaire for use in family studies.
This adaptation proved to be reliable when differentiating from primary headaches, and to be in very good agreement with the standard for comparison. However, discriminating between migraine with and without aura still relays on a specialist evaluation. This article describes the validation of this questionnaire.
The chromosome 19 apolipoprotein E/CI/CII gene cluster was examined for evidence of linkage to a familial Alzheimer disease (FAD) locus. The family groups studied were Volga German (VG), early-onset non-VG (ENVG; mean age at onset
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Cerebellar hypoplasia is a rare malformation caused by a variety of etiologies. It usually manifests clinically as non-progressive cerebellar ataxia with or without mental retardation. We further characterize a syndrome of autosomal recessive cerebellar hypoplasia in the Hutterite population, referred to as dysequilibrium syndrome (DES). We reviewed 12 patients (eight females, four males; age range 4 to 33 y) with this syndrome. Patients were examined and underwent a standard set of investigations to characterize better the clinical features, natural history, and neuroimaging of this syndrome. DES is an autosomal recessive disorder with distinct clinical features including global developmental delay, late ambulation (after age 6 y), truncal ataxia, and a static clinical course. Neuroimaging is characterized by hypoplasia of the inferior portion of the cerebellar hemispheres and vermis, and mild simplification of cortical gyri.
Understanding the beliefs and knowledge related to women's sexuality is important when working with unique religious groups in order to provide culturally appropriate care. An exploratory, descriptive qualitative study generated knowledge, beliefs, and practices related to menstruation, ovulation, and family planning among Low German-speaking (LGS) Mennonite women (n = 38). There is a pervasive silence that surrounds sexuality among this group, who have a limited understanding of the physiological changes they experience. Honoring religious principles and family and community expectations through acceptable female behavior is essential. Adherence to religious principles varies by family but is not shared with the group to avoid disfavor.
Ontario is home to a sizeable, recently established immigrant population whose cancer mortality has until now remained unexamined. The province's six largest immigrant groups (British, Italian, German, Dutch, Polish and Soviet) were investigated to compare their cancer mortality experience with that prevailing in Ontario and in their countries of birth for the period 1969 through 1973. Standardized mortality ratios (SMRs) were computed from data from Statistics Canada and the World Health Organization (for 1971) for five sites of cancer. The rates of death from stomach cancer were significantly higher for the immigrant groups (except the Germans) than for the Canadian-born (SMRs 158.6 to 256.1) and were significantly lower for the immigrants (except the Dutch) than for the populations of their countries of birth (SMRs 26.5 to 72.9). The rates of death from colorectal cancer and cancer of the breast tended to be lower among the immigrants. Most male immigrants had high rates of death from lung cancer relative to the Canadian-born, whereas their female counterparts had relatively low rates. For most of the immigrant groups the rates of death from prostate cancer closely resembled those prevailing in the country of birth. Displacement of cancer mortality experience towards that in Ontario was most evident for Polish immigrants. It may have been too soon to see trends among the more recent immigrants (Italian, German and Dutch), who, for the most part, had not yet reached the age of highest cancer risk. Ontario should provide a valuable resource for further studies of lifestyle and environmental determinants of cancer.
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We used the nationwide Swedish Family-Cancer Database to analyze cancer risks in Sweden-born descendants of immigrants from European and North American countries. Our study included close to 600,000 0-66-year-old descendants of an immigrant father or mother. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for 17 cancer sites using native Swedes as a reference. All cancer was marginally below the Swedish incidence in offspring of immigrant origin. Decreased SIRs were observed for breast cancer among Norwegian descendants, melanoma among descendants of Hungarian fathers and ovarian and bladder cancer among descendents of Finnish mothers, all consistent with the difference in cancer incidence between Swedes and the indigenous populations. Cervical cancer was increased in daughters of Danish men, whereas thyroid cancer and non-Hodgkin's lymphoma were in excess in offspring of parents of Yugoslav and Asian descent. Even these results agreed with the high incidence rates in parents compared to Swedes, except that for non-Hodgkin's lymphoma other explanations are needed; these may be related to immune malfunction. Comparison of the results between the first- and the second-generation immigrants suggest that the first 2 decades of life are important in setting the pattern for cancer development in subsequent life. Birth in Sweden sets the Swedish pattern for cancer incidence, irrespective of the nationality of descent, while entering Sweden in the 20s is already too late to influence the environmentally imprinted program for the cancer destiny.
In the last months of the second World War, 250,000 German refugees landed in Denmark. A third of them were children under the age of 15. Seven thousand German refugee children under the age of five died in Denmark in 1945. Using birth certificates and death certificates from the Danish national archives and burial lists from the German refugee cemetaries I have collected data to reveal causes of death, age distributions and time of the deaths of the 7000 fatal cases among children under the age of five. Three thousand children under the age of one, 2000 children one year old and 2000 children 2-4 years old died. Most of them died just before and after the German surrender, but many died in the months following the German surrender. The infant mortality was extremely high all during 1945. The infants died from diseases due to malnutrition, but the older the children the more likely the causes of death were due to infectious diseases such as pneumonia, measles, diphtheria and gastroenteritis.
Low-German-speaking (LGS) Mennonites are a conservative religious group that has migrated from Eastern Europe to Canada and then to countries such as Mexico. They are now returning to Canada in large numbers. They adhere to religious principles based upon a literal interpretation of the Bible. This conservative religious group provides opportunities for nurses and midwives to implement culturally competent care.
The purpose of this article is to discuss LGS Mennonite women's childbearing knowledge and beliefs to develop and implement care that considers and includes their conservative religious beliefs.
An exploratory, descriptive study was conducted to generate information through open-ended interviews with 38 LGS Mennonite women about their knowledge, beliefs and practices related to childbearing. Data collection and analysis occurred simultaneously; emerging themes were discussed by the research team to ensure a contextual understanding of the data.
The participants engage in proscribed practices ('turning the baby') and adhere to specific dietary measures (increasing dairy products) during pregnancy to ensure a healthy birth outcome. During the post-partum, extensive support is provided by other Mennonite women to assist the mother and newborn during this important transition.
Building trust and working in a respectful manner with religious groups such as the LGS Mennonites are a cornerstone of culturally competent nursing practice.
Demographic, smoking and dietary information was obtained from a cohort of 17,633 white American men, largely of Scandinavian and German descent, who responded to a mailed questionnaire in 1966. After 20 years of follow-up, 50% to 90% increases in mortality from stomach cancer (75 deaths) were found among foreign-born, their children, and among residents of the North Central states. An association was seen with low educational attainment and laboring or semiskilled occupations, primarily among immigrants and their children. Risk was evaluated in subjects who regularly smoked cigarettes (RR = 2.6, 95% CI = 1.1 to 5.8). A significant dose-response trend was observed, with subjects who smoked 30 or more cigarettes per day having more than a five-fold increased risk compared with those who never smoked. Elevated risks were also found for pipe smoking and smokeless tobacco use, but not for alcohol consumption. Analysis of dietary consumption of nine food groups revealed no significant associations with stomach cancer. However, total carbohydrate intake and a few individual food items (salted fish, bacon, cooked cereal, milk, and apples) were associated with increased risk. The findings of this prospective study of a high-risk population add to the limited evidence relating tobacco consumption to stomach cancer risk and suggest clues to ethnic, geographic, and dietary risk factors.
Comment In: Cancer. 1992 Jun 1;69(11):2867-81571920
General and illness-related locus of control play an immensely important role in the adherence and cooperation of patients in their therapy. Until now, culture-specific aspects of these subjective theories have rarely been investigated. However, in view of the growing proportion of migrants in the German population, they are becoming increasingly significant. In a project supported by the Volkswagenstiftung (Volkswagen Foundation), a total of 607 healthy people were surveyed. The sample includes 307 ethnic German migrants from the successor states of the former Soviet Union (descendents of German origin who had emigrated to Russia during the 18th and 19th centuries) and 300 native Russians in Russia. They were compared with 100 Germans (matched from a previous study). The data were collected using questionnaires entitled "Multidimensional Health Locus of Control (MHLC)" and "Illness-related Locus of Control". The ethnic German migrants differed from the Russian sample in their health beliefs and attitudes towards medicine. However, in the first 18 months after migration, hardly any changes were observed. Fatalistic factors played only a minor role. Locus of health control was associated with beliefs about recovery from myocardial infarcts and tumours. Socio-demographic variables were of varying significance in the individual cultures. Gender influences on health beliefs were different in the subsamples. The level of education had only a minor influence on health attitudes. For those individuals who were acquainted with an ill person, internal factors in treatment of myocardial infarct and external psychosocial factors in cure of cancer played a larger role.