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BACKGROUND: The London Health Sciences Centre Home Safety Program (HSP) provides safety devices, education, a safety video, and home safety checklist to all first-time parents for the reduction of childhood home injuries. The objective of this study was to evaluate the HSP for the prevention of home injuries in children up to 2 years of age. METHODS: A program evaluation was performed with follow-up survey, along with an interrupted time series analysis of emergency department (ED) visits for home injuries 5 years before (2007–2013) and 2 years after (2013–2015) implementation. Spatial analysis of ED visits was undertaken to assess differences in home injury rates by dissemination areas controlling differences in socioeconomic status (i.e., income, education, and lone-parent status) at the neighborhood level. RESULTS: A total of 3,458 first-time parents participated in the HSP (a 74% compliance rate). Of these, 20% (n = 696) of parents responded to our questionnaire, with 94% reporting the program to be useful (median, 6; interquartile range,2 on a 7-point Likert scale) and 81% learning new strategies for preventing home injuries. The median age of the respondent's babies were 12 months (interquartile range, 1). The home safety check list was used by 87% of respondents to identify hazards in their home, with 95% taking action to minimize the risk. The time series analysis demonstrated a significant decline in ED visits for home injuries in toddlers younger than2 years of age after HSP implementation. The declines in ED visits for home injuries remained significant over and above each socioeconomic status covariate. CONCLUSION: Removing hazards, supervision, and installing safety devices are key facilitators in the reduction of home injuries. Parents found the HSP useful to identify hazards, learn new strategies, build confidence, and provide safety products. Initial finding suggests that the program is effective in reducing home injuries in children up to 2 years of age

Aim: Suicidal behaviours (suicide attempts and suicides) are common among individuals experiencing, or having recently experienced, a first-episode psychosis (FEP). Current interventions for suicidal behaviours are crisis driven and focused on hospital admission of patients at imminent risk of ending their lives. This paper aims to describe ideas for universal, selective and indicated strategies that may complement existing practices to suicide risk management in first-episode patients. Methods: Key findings from the Suicidal Behaviours in FEP Project were used to develop suggested interventions. The project examined the temporal course of suicide risk, common characteristics of suicidal behaviours and predictors of suicidal behaviours in 699 patients with FEP. Results: Key findings included: (i) 12% of FEP cohort engaged in suicidal behaviours during treatment (up to 3 years); (ii) first month of treatment conferred the highest suicide risk; (iii) 64% of suicidal behaviours were overdoses, usually on antipsychotics; (iv) 20% of suicidal behaviours occurred on psychiatric units and all involved hanging/strangulation; (v) most suicidal behaviours were impulsive, precipitated by psychosocial stressors and with serious intent; and (vi) proximal non-suicidal self-injurious behaviour and proximal negative life events were the strongest predictors. Conclusion: Comprehensive approach by mental health services to prevention of suicidal behaviours among first-episode patients could be facilitated by: delineating safe quantities of prescribed medications available to outpatients; regular audits of fixtures on inpatient units; enhancing risk recognition by family members; routinely monitoring suicide risk levels; developing crisis cards with all new FEP patients to facilitate help seeking during distress; and skills training programs targeting distress tolerance, interpersonal effectiveness and problem-solving.

Objectives: Understanding the characteristics of suicide attempts in people undergoing treatment for first episode psychosis (FEP) may have implications for risk management at a service level and local suicide prevention strategies. Although studies have focused on identifying individual-level risk factors for suicide attempts in this patient group, none have yet conducted an in-depth profile of suicide attempts. The aim of the present study was to examine the characteristics of suicide attempts in young people during the initial 18 months of treatment for FEP. Method: A retrospective medical record audit study of a cohort of patients accepted for treatment at a specialist FEP service between 1/12/2002 and 30/11/2005. Results: Of 607 patients, 73 (12%) attempted suicide during treatment. Of these 73, most (72.6%) attempted suicide on one occasion. The majority of attempts (85.3%) occurred when patients were treated as outpatients and were in regular contact with the service. Suicide attempts tended to be impulsive (77.6%), triggered by interpersonal conflict or distress due to psychotic symptoms. Two thirds involved self-poisoning, usually by overdose of prescribed medications. All inpatient suicide attempts were by hanging or strangulation. Individuals infrequently sought help immediately before or after the attempt; if help-seeking occurred, informal sources of support were contacted. Conclusions: To reduce the number of suicide attempts among individuals treated for FEP, psychiatric services could consider: restricting the amount of medication prescribed per purchase; individualised suicide risk management plans for all newly admitted patients, including those who do not appear to be at risk; stringent reviews of inpatient psychiatric units for potential ligature points; providing information and psycho-education for significant others in recognition and response to suicide risk; fostering patients' problem solving and conflict resolution skills; and regular risk assessment and close monitoring of patients, particularly during the high risk period of 3 months after a suicide attempt.

Objective:To undertake a 6-year longitudinal investigation of the relationship between the built environment (perceived and objectively measured) and change in body mass index (BMI). Specifically, this research examined whether change in BMI was predicted by objectively measured neighborhood walkability and socioeconomic status (SES), and perceived neighborhood characteristics (for example, crime, traffic and interesting things to look at) in addition to other factors such as age, gender, education, physical activity, fruit and vegetable consumption and smoking.Design:Longitudinal studySubjects:500 adults who provided complete data in 2002 and 2008 and who did not move over the course of the study (47.8% female; age in 2002: 18-90 years).Measurements:Telephone surveys in 2002 and 2008 measuring perceptions of their neighborhood environment and demographic factors. Objective measures of neighborhood characteristics were calculated using census data and geographical information systems in 2006.Results:Age, neighborhood SES and perceived traffic were significantly related to increased BMI over the 6 years. Younger participants and those in lower SES neighborhoods were more likely to have increased BMI. Agreement with the statement that traffic made it difficult to walk also predicted increased BMI.Conclusion:This study adds to the literature to show that BMI increased in low SES neighborhoods. Although more research is needed to fully understand how neighborhood SES contributes to obesity, it is without question that individuals in socially disadvantaged neighborhoods face more barriers to health than their wealthier counterparts. This study also calls into question the relationship between walkability and changes in BMI and emphasizes the necessity of longitudinal data rather than relying on cross-sectional research. Language: en

Paracetamol (acetaminophen) is the most common drug taken in overdose in the UK, accounting for 48% of poisoning admissions to hospital and being involved in an estimated 100–200 deaths per year. In 1998, the UK government introduced legislation that reduced the maximum pack size of all non-effervescent tablets and capsules containing aspirin (acetylsalicylic acid) or paracetamol that can be sold or supplied from outlets other than registered pharmacies from 25 to 16 tablets or capsules. This article reviews the literature to determine the effectiveness of the legislation, focusing specifically on paracetamol poisoning. Seventeen studies on this subject were identified. Three studies found reductions in mortality rates; one study found an increase in mortality rates, while one found an initial reduction followed by an eventual increase; three found no significant difference in mortality rates before and after introduction of the legislation. Five studies found reductions in admissions to liver units, three of these finding a reduction in liver transplantation rates; two further studies found no change in liver function tests and rates of paracetamol-induced acute liver injury or failure. Four studies found a sustained decrease in hospital admissions, while two found an initial decrease followed by an eventual increase. One study found a decline in admissions for paracetamol poisoning and an increase in admissions for non-paracetamol poisoning. Sales data are conflicting, with two studies finding no significant difference in paracetamol sales before and after the introduction of the legislation and one reporting a decline. The severity of overdose appears to have decreased since the maximum permitted packet size was reduced, with five studies reporting a reduction in the number of severe overdoses (measured by numbers of tablets ingested, serum paracetamol concentrations and usage of antidotes). Only two studies reported an increase in the number of severe overdoses. Paracetamol-associated mortality rates, admissions to liver units/liver transplants, hospital admissions and the severity of paracetamol overdose appear to have been decreasing since 1998. However, one study showed that the reductions in mortality and hospital admissions began in 1997; therefore, the contribution of the 1998 legislation to the observed changes is unclear. Most of the studies are based on short-term follow-up so it is difficult to draw any conclusions regarding long-term trends. Many of the studies were also restricted to relatively small areas of the UK; this, combined with a variety of outcome measures, makes it difficult to distinguish any conclusive trends. The studies also suffer from a lack of comparison and control groups. Some studies do not clearly differentiate between the paracetamol preparations covered by the legislation and those not. The limited number of studies to date, combined with a variety of outcome measures, make it difficult to determine with accuracy whether or not the legislation has been a success. More long-term studies are needed to fully assess the impact of the legislation.

The subgluteal approach is common for sciatic nerve block. Although the surface landmarks are clear, the depth of this nerve at this level is difficult to judge. The purpose of this study is to establish a method of estimating the sciatic nerve depth using the anteroposterior (AP) diameter of the thigh as a marker.The study was undertaken in 2 phases. Phase 1 entailed review of 100 magnetic resonance images (MRIs) of the pelvis and proximal lower extremity of patients. Measurements were taken of the AP diameter of the thigh at the midpoint of the lesser trochanter and then compared with distances of the sciatic nerves from the skin of the posterior aspect of the thigh at the same level. Phase 2 involved enrolling 40 patients undergoing lower-extremity surgery for whom subgluteal sciatic nerve blocks were indicated. The AP diameters of the thighs were measured from the subgluteal groove to the inguinal groove with the patient in the supine position. Placing the patient in the lateral position, the subgluteal sciatic block was then performed by using a stimulating needle. The distances from the skin at which the sciatic nerves were actually found, as estimated by maximum motor response to stimulus, were noted.Phase 1 showed a mean AP diameter of 18.94 cm +/- 2.61 cm (mean +/- standard deviation [SD]), mean nerve depth of 6.51 cm +/- 1.46 cm (mean +/- SD), and a linear regression slope of 0.48. Phase 2 showed a mean AP diameter of 16.28 cm +/- 2.73 cm (mean +/- SD), a mean nerve depth of 6.99 cm +/- 1.39 cm (mean +/- SD), and a linear regression slope of 0.43. The thigh diameters differed (P.001) between the groups, but there was no difference in the depth to the sciatic nerve between the 2 groups (P = .07).Comparing phase 1 and phase 2 datasets shows the slopes of linear regression lines are nearly parallel. The clinical data from phase 2 verify the anatomical data collected in phase 1 and show that the sciatic nerve depth to AP diameter ratio is 0.43 or the depth of the sciatic nerve is approximately 43% of thigh diameter if the patient is positioned in the lateral decubitus position.

This study develops and tests a theoretical model to explain sibling violence based on the feminist, conflict, and social learning theoretical perspectives and research in psychology and sociology. A multivariate analysis of data from 651 young adults generally supports hypotheses from all three theoretical perspectives. Males with brothers have significantly higher levels of sibling violence than the other three types of sibling pairs. As predicted, conflict and abuse between parents are associated with negative parent-child interactions, which in turn are related to problems in siblings' relationships with each other. All of these predict sibling violence.

Drawing on three theoretical perspectives (feminist, conflict, and social learning), an integrated analytical model of adolescence sibling violence and abuse is proposed. The model suggests that certain characteristics of the parents' relationship, various aspects of parent–child relations, and characteristics of the sibling relationship are major components in explaining sibling violence and abuse. These are mediated by individual sibling characteristics and sibling verbal conflict. The model should enable researchers to systematically examine, in a more holistic way, the factors related to violence and abuse, and to assess their relative importance in accounting for these phenomena.

Using a wide variety of measures of psychological well-being obtained from a representative sample of married men and women in Bangkok, Thailand, we examine gender differences in psychological well...

This paper examines the effect of one form of chronic stress--household crowding--on psychological well-being, as measured by multiple inverse indicators of psychological well-being. We rely on data from a large (n = 2017) random sample of households in Bangkok, Thailand, a context that has a higher level and broader range of crowding than typically found in the United States. Objective household crowding is found to be detrimental to psychological well-being, controlling for a number of background characteristics. The effect of objective crowding is mediated by subjective crowding, which has strong, consistent and direct detrimental effects on well-being. There is no evidence of a gender effect. Extended family households are not uncommon in Bangkok, but the effects of objective and subjective crowding are similar in both two- and three-generation households, as well as in one- and multiple-couple households. The argument that subjective crowding is an effect, rather than a cause, of psychological well-being is examined and rejected. The findings suggest that crowding, as a chronic source of stress, constitutes a major threat to psychological well-being. Although the empirical analyses are based on data from one city, we frame the issue of household crowding in a historical and theoretical context in order to suggest in which cultural settings household crowding is most likely to have detrimental effects on psychological well-being.

Prior studies have found only a modest relationship between objective and subjective crowding, defying logic and commonsensical notions of why people feel crowded. Using data from a representative sample of Bangkok, Thailand, where the level of household crowding is four times that in western societies, we explore several possibilities of why this is the case. Examining seven different indicators of objective crowding, our analyses suggest that the modest relationship is not an artifact of measurement. Contrary to the assumption of prior investigations, the findings indicate that the objective-subjective crowding relationship is nonlinear and that there is a ceiling effect muting the impact of increased objective crowding. The analyses further suggest that the strength of the relationship is mitigated somewhat, with part of the feeling of being crowded accounted for by household circumstances, such as the degree of control an individual has over the use of household space.

Cities in developing countries are growing ever larger and more dense, fostering congested household environ- ments. Using data from Bangkok, this paper examines the effect of household crowding on multiple measures of family relations, looking at the possible "social costs. " The data show that objective household crowding does increase marital instability and arguments, and parent-child tensions. Subjective household crowding affects not only these three aspects offamily relations, but also results in more frequent disciplining of children. These effects are largely mediated by psychological stress. The paper rejects the argument that subjective crowding is an effect, rather than a cause, of marital and family relations, and shows little difference between wives' and husbands' reactions to crowding. The consequences of household crowding, generally found to be selective and modest in North America and Europe, are stronger in Bangkok, a city with crowded conditions more typical of less devel- oped nations. From Durkheim ((1893) 1947) forward, most theories of social integration have viewed population size and density as facilitating the family's role as a central mechanism for the stabilization of individuals and the maintenance of broader social networks. Crowding re- search, especially that concerning the household or the "primary environment" (Stokols 1978), has drawn attention to the obverse (Booth 1976; Gove, Hughes, and Galle 1979; Mil- gram 1970), stressing the negative effects on close social bonds when there is crowding. The potential negative effect of crowding is a salient issue in less developed countries where urban populations continue to grow. In this paper we extend prior work on household crowding as it affects families. While most of what we know about the effects of human crowding is based on North American and European studies, we seek to extend this knowledge base by presenting analyses of data col- lected in Bangkok, Thailand, a city in which average households are four times as crowded as those in North America. Cross-cultural research such as this has the potential not only to increase the variance in the variables of interest, but to test the generalizability of explana- tions. With Thai data, we can more precisely assess the "costs" when household crowding reaches levels of the magnitude typical of the non-Western world.

The proposition that poor housing and congested living conditions have a detrimental impact on health has been promulgated for at least 150 years. At a minimum, two major causal mechanisms are thought to be involved in the relationship between crowding and physical health. First, high levels of household crowding can produce stress that leads to illness. Second, through shared physical proximity, household congestion contributes to the spread of communicable disease. The outcomes can be exacerbated by poor quality housing. A significant body of research, conducted primarily in affluent countries, has documented the detrimental effects of housing conditions on a variety of illnesses, including various contagious diseases. Poor housing has even been linked to high infant and adult mortality rates. The view that poor housing conditions and household crowding inevitably leads to poor health is challenged, however, by several observers, who question the role played by both crowding and housing quality. Most existing research has been conducted in affluent countries. Little is known, however, about the nature of these relationships within the context of less developed countries, where health status and housing quality are generally much poorer and where levels of household crowding are generally higher. Determination of the effects, if any, of housing quality--including household crowding--on physical health in developing countries is particularly important given the rapid growth of their urban populations and the difficulty of increasing the physical infrastructure fast enough to keep pace with this growth. This paper reports on an investigation of the impact of housing conditions and household crowding in the context of one developing country, Thailand. Using data from a representative sample of households in Bangkok (N = 2017), our results provide reason for some skepticism regarding the influence on housing on health, at least in its objective dimensions. While the skepticism of some is based on a reading of the evidence in Western countries, we likewise find that, in Bangkok, objective indicators of housing quality and household crowding are little related to health. We do find, however, that subjective aspects of housing and of crowding, especially housing satisfaction and a felt lack of privacy, have detrimental effects on health. Furthermore, psychological distress is shown to have a potent influence on the physical health of Bangkokians. Our analyses suggest that all three factors have independent effects on health outcomes bearing on both men and women.

Ethological studies suggest that animal populations that live in crowded conditions display a number of behaviors that tend to limit the size of the population, such as aberrant forms of sexual behavior, small litter sizes, a higher incidence of spontaneous abortion, ineffectual maternal care, and even cannibalism of their young. Studies of household crowding in North America cities have produced only modest and selective evidence that crowding has similar effects among humans. In this paper, we examine the effect of household crowding on marital sexual relations, on desire for additional children, and on fetal and child loss in Bangkok, Thailand, a city with a much wider range of household crowding than is typically found in North America. In spite of the wider range, and higher mean level of crowding, we find that both the objective and subjective dimensions of crowding have only modest selective effects on sexual and reproductive behavior.In ethological studies, animals have been observed to exhibit aberrant forms of sexual behavior when forced to live in crowded conditions. Studies in humans have indicated a possible connection between crowding and frequency of coitus, desire for additional children, the effective use of birth control, and the survival of offspring. The psychological distress which may arise from crowding may also have an impact on reproductive behavior. Because these studies give very little indication of possible findings in a very crowded area, focus groups were convened to lend direction to the development of a questionnaire for use in Bangkok, Thailand, where people live in conditions (12.25/sq. meter) which would be comparable to 17 people in a 1,500 sq. foot house in the West. The choice of Thailand for a research site allowed an exploration of the role of culture in reactions to crowding. In fact, the modest demeanor of the Thai people did mean that the subject of privacy was consistently raised in the focus groups. The resultant survey was administered to 1,399 wives and 618 husbands in families living in Bangkok for at least 1 year in 1988 who had at least 1 child with the mother under 45 years old. The average household samples had 5.5 people, including nuclear and 3-generation families. Scales were composed for perceived crowding, lack of privacy, and psychological distress. Findings were also tabulated for 1) frequency of sexual relations/month by sex, age, years married, age of oldest child, education, income, number of generations, number of married couples in the household, and health of respondent; 2) zero-order correlations among crowding, sexual relations, and reproductive behavior by frequency, reluctance, temporary cessation, desire for additional children, using birth control, forgot to use birth control, lack of privacy prevents use of birth control, child loss, miscarriage, and abortion; and 3) a standardized coefficient regression for the relationship between measures of reproductive behavior and objective and subjective crowding with the following controls: persons/room, lack of privacy, and psychological distress. Analyzing the data revealed that the objective level of crowding (persons/room) leads to greater reluctance to engage in sexual relations and some periods of temporary cessation, but does not affect frequency, desire to have children, use of birth control, or fetal and child survival. Subjective crowding leads to similar results, but these parents are less likely to have ceased sexual relations or to have lost a child. Lack of privacy affects only one measure examined; it increases reluctance to have sexual intercourse. Thus, these findings suggest that household crowding has a very minor impact, if any, on sexual and reproductive behavior.

Extending prior research on the intergenerational transmission process, we examine the influence of parental divorce and parental unhappiness on the marital and family relations of their adult offspring. Using interview data from a national sample of married persons, parental divorce, it is found, has little associaton with the various aspects of family relations examined. It does relate, however, to several dimensions of the adult offsprings' marriages. In contrast, marital unhappiness in the parental generation is strongly related to both the family and marital relations of their married children. The findings indicate that remaining in an unhappy marriage has many more adverse, and stonger, effects on the next generation than parental divorce does.

INTRODUCTION: Available work from North America indicates that same-sex attracted (SSA) individuals enjoy aspects of rural life but nonetheless report encountering homophobia and experiencing isolation from SSA networks. The experience of prejudice and social isolation are often associated with psycho-social distress among the general population of same-sex attracted individuals. Little is known of how SSA women experience life in rural areas of Australia and how this influences their psycho-social wellbeing. METHODS: This was a small-scale qualitative study using guided interviews to explore the experience of SSA women living in rural areas of South Australia. Seven women identifying as same-sex attracted were interviewed. In addition, a woman who provides a counseling and support service for same-sex attracted women was also interviewed. All interviews were audiotaped and transcribed verbatim and were then analysed for emergent themes. Summaries of the interviews, based on the emergent themes, were sent to all interviewees so that they could verify or challenge the validity of the emergent themes, as well as to allow them to remove any information they felt might identify them. RESULTS: Most women had felt 'different' while growing up; almost unanimously describing themselves as having been 'tomboys'. However, the lack of visible SSA role models in rural areas, together with a lack of SSA social networks, did not allow some of the women to identify and name their same-sex attraction. For many of the women in this study, it was visits to the state capital, where they had the opportunity to meet other SSA women, which precipitated them identifying themselves as same-sex attracted. In light of this new knowledge, some women denied their same-sex attraction and entered into heterosexual relationships, often entailing marriage. Other women entered same-sex relationships but tried to keep them invisible within their communities. Rural communities are frequently close-knit environments, where 'everybody knows everybody'. In such settings, much of the conduct of daily life is visible to other community members and may be closely scrutinized. In such locations, women initially try to keep their same sex attraction invisible. Women rarely comment on the threat of violence that underpins the attempt to keep same-sex identity or relationships secret. Nevertheless, even while it remains a largely unarticulated factor, it was a powerful one fueling the maintenance of their invisibility. Fear of violence ranges from the threat of overt physical violence to more commonly voiced concerns over 'mundane' harassment. Fear of social violence, in the form of rejection and ostracism, is the most frequently nominated factor motivating women to keep same-sex attraction invisible in rural settings. While keeping their same-sex identity and relationships invisible offers women some safety from physical and social violence, it may pose dangers for their psycho-social well-being. Trying to keep SSA relationships invisible within communities involves women censoring their behaviour while in public. Invisibility also gives rise to isolation, since women do not have the opportunity to form same-sex attracted social networks. Furthermore, some women experience great psycho-social distress as their awareness of their same-sex attraction becomes increasingly incongruent with the established pattern of their lives. Women find it very difficult to seek appropriate forms of help if they do experience psycho-social problems. Concerns over confidentiality means that women are extremely reluctant to seek help and support locally. Distance is a powerful mediating factor in both women's experience of distress and their capacity to seek help to ameliorate it. For women who live in closer proximity to the state capital, the capacity to meet other SSA women and engage in same-sex attracted social activities helps ease their sense of difference and isolation. Likewise, should they wish to utilize counseling or support services, it is relatively easy for them to do so. However, women living at greater distances from a capital city experience greater isolation and loneliness. Moreover, their ability to confidentially access appropriate services is markedly curtailed. CONCLUSIONS: Same-sex attracted women living in rural areas need social contact with other SSA women, where their safety and confidentiality can be assured. They also need access to safe, confidential and appropriate services. Telephone and internet services are one way of anonymously and confidentially giving women access to information and support. Peer support networks, internet and telephone networks need to be further developed. Ways in which specialist gay and lesbian services and locally based health and human services could collaborate to provide accessible and acceptable services and to help women develop safe and confidential social networks need to be identified and trialled. Language: en

Identification of elicited muscle twitches while performing infraclavicular block of the brachial plexus is often confusing but is critical for success of the block. An easily defined endpoint when evaluating these motor responses to neurostimulation is essential, as it is necessary to block the appropriate cord or cords. In addition to an extensive review of the motor and sensory neuroanatomy of the upper extremity, we describe an easy method to learn and remember the motor response to stimulation of each of the cords of the brachial plexus. If the arm is positioned in the anatomical position, the 5th digit (pinkie) moves laterally (pronation of the forearm) when the lateral cord is stimulated, posteriorly (extension) when the posterior cord is stimulated, and medially (flexion) when the medial cord is stimulated. The pinkie thus moves “toward” the cord that is stimulated.

Previously divorced and remarried couples have a higher probability of divorce and decline in marital quality. Models which have explained this behavior focus on: willingness to leave marriage; selection; socioeconomic status; the remarriage market; and incomplete marriages. Each model is examined among a population of marrieds and remarrieds to distinguish attributes and the extent to which these attributes increase the probability of decline in marital quality or divorce. Data were obtained from a sample of 2033 marrieds 55 years old who were interviewed over the telephone in 1980, 1983, and 1988 in the Marital Instability Over the Life Course Study. Incomplete marriage was measured by whether and to what extent parents or parents-in-law made contact and the number of relatives that party was close to. Willingness to leave was based on attitudes to divorce and the ability to handle emotion and financial affairs if the marriage ended. Selection referred to poor marriage material (drugs or alcohol, criminal conduct, mismanagement of money, immature behavior. Socioeconomic status was reflected in occupational status, educational levels, and income. The marriage market was a measure of age, education, and religious differences. Marital quality was examined in terms of happiness, interaction, disagreement, and divorce proneness. Multiple classification analysis was used to compare attributes by marital history. The methods of Kessler and Greenberg were used to examine changes in marital quality over time in first time marriages and remarriages. The results indicate that individuals in remarriages have relationships with attributes which potentially lower marital quality and increase the probability of divorce. When both individuals have prior marriage and divorce experience, there is even lower social integration, greater willingness to leave marriage, higher probability of marrying as a teen, lower socioeconomic status, and greater likelihood of age differences. Remarriage variables and marital quality variables both showed linear relationships. Remarriage variables and marital quality variables both showed linear relationships. In the cross sectional analysis of the 1980 data there is a statistically significant relationship with attributes which potentially lower marital quality in 1980 indicates remarried persons are more prone to lower marital quality than people in first marriages.

The current study uses survey data from a representative sample of 619 husbands residing in Bangkok, Thailand, to assess their use of physical force against their wives. Multivariate analyses are performed and a series of logistic regressions are estimated for an integrated theoretical model derived from resource, structural, and social psychological theories. The results provide strong support for the importance of socioeconomic status, marital instability, and verbal marital conflict as predictors of Thai wife abuse.

In Thailand like the US womens higher rates of illness and health service use imply that they are "sicker." But as in the US females live longer than males. Based on a large representative sample of Bangkokians the authors find that married women report more sickness are more likely to utilize health services and according to self-reports have poorer health. Western literature suggests five prominent explanations for gender differences in health: biological risks acquired risks psychosocial aspects of symptoms and care health-reporting behavior and prior health care and caretakers. However analyses show that these explanations largely fail to account for morbidity differences between Thai men and women. The observed gender differences in health among Thais remain significant after eliminating pregnant women and new mothers and after controlling for several aspects of acquired risk. Problems associated with the reproductive system among Thai women along with greater psychological distress appear to account for most of the gender differences in health. The theoretical implications of these findings are discussed. As for the apparent contradiction between gender differences in health and mortality in Thailand the evidence indicates that Thai men like their American counterparts suffer from more serious chronic ailments that may explain their mortality rates. (authors)

A link between employment outside the home and instability in the marriages of married women has long been suspected. However two decades of empirical research have produced mixed findings and have yielded few firm conclusions about how wives employment increases marital instability. The present study provides further evidence on the employment-instability linkage examining the direct and indirect effects employment may have. Using data from a study of intact marriages in Bangkok Thailand the analyses indicate that the effects of employment per se and the number of hours worked are class-linked and where present tend to be mediated by various marital processes....The findings in general lend strong support to a process model of marital instability a model previously found to largely account for instability among American couples. (EXCERPT)

Panel data from a national random sample are used to investigate the effects of children leaving home on parental well-being. The "empty nest" is associated with significant improvements in marital happiness for all parents, regardless of parent's or children's characteristics. Overall life satisfaction improves significantly only under two conditions: when there is frequent contact with nonresident children or when there were young teens in the 1983 household. For both measures of parental well-being, the positive effects of the empty nest appear to be strongest immediately after the children leave. These findings, coupled with the high levels of post-launching contact, suggest that while parents experience a modest post-launch honeymoon, the parental role remains important to parental well-being.

Interview data from a national sample of 2,034 married persons are used to examine the effect of wives'outside employment on marital instability. In this study, marital instability is defined as including the gamut of activities from thinking about and discussing divorce to actually filing for either separation or divorce. A recursive structural equation model is used to test the extent to which the observed positive relationship between wife's employment and marital instability is mediated by wife's employment and marital instability of the marriage is eroded entails the wife's income level and some combination of spousal disagreement and low marital satisfaction.

UNIVERSAL patriarchy, asserting that males are always dominant, is firmly established as part of our conventional and scientific wisdom. Close examination of this contention shows it, however, to be wanting on both conceptual and methodological grounds. Further suspicion as to its truth claim derives from an inspection of a dubious case, that the Dahomey of Africa, in whose society women equally occupied positions of authority with men in all major institutional sectors of society. Coupled with these conceptual, methodological, and empirical difficulties, the evolutionary scenario—man as hunter—commonly used to support the notion of universal patriarchy is found to be more of a political convenience than an adequate explanation of dominance patterns. Taken together, these considerations strongly indicate the implausibility of sustaining universal male dominance as a scientific generalization. Some of the implications for family studies of its continued acceptance are noted.

The declining prevalence of the nuclear family in the United States is examined, and the consequences for the healthy development of children are considered. Attention is given first to research supporting the claim that nuclear families provide the optimum environment for child rearing and then to studies presenting differing results. Methodological and conceptual issues concerning studies in family structure are discussed. The author concludes that family structure in and of itself has little effect on child development and that an alternative theory, de-emphasizing structural inputs, is needed.

"Despite the prevalence of shared housing in Australia, almost one-third of all households, little is known about who are the people who share accommodation, and why they do so. Using a sample of 4,560 households, this paper presents a demographic profile of shared dwellings and tests some of the prevailing assumptions about why certain groups may have a propensity to share. Some of the implications of the findings for existing housing policies are pointed out and directions for future research are suggested."

This study examines the causal processes that lead to the widely observed negative association between presence of children and marital happiness. Using a nationwide panel of 1535 married individuals, we find support for two primary causal mechanisms. First, the presence of children is associated with differences in marital structure (lower interaction, more dissatisfaction with finances and the division of labor, and more traditionalism of the division of labor) that are, in turn, associated with lower marital happiness. We also find, however, that the relationship between marital happiness and children is partially spurious. The presence of preschoolers and especially the birth of a first child serve to reduce the likelihood that unhappily married people will divorce within a three-year period. As a result, a larger proportion of unhappily married people is retained temporarily in the parent population and thus contributes to the observed negative relation between presence of children and marital happiness.

The dimensionality of five conceptually distinct components of marital quality was evaluated in a representative national sample of 1845 married people. Confirmatory factor analysis found two dimensions, one consisting of scales of marital happiness and interaction; the other, of marital disagreements, problems, and instability. Further examination of the two dimensions showed that they operate in distinctly different ways over forms of marital structure including wife's employment, marital duration, sex, and presence of children. It was concluded that scales of marital quality that combine measures from these two dimensions are likely to yield ambiguous findings and contribute little to an understanding of marital process.

This study uses a national sample of married persons under age 55, interviewed in 1980 and again in 1983, to estimate why divorce and marital instability vary by age and duration of marriage. Results indicate that the accumulation of assets substantially reduces the propensity to divorce. We also find that several important correlates of divorce and instability (age at marriage, health, social integration, and income) interact with age and duration. In general, these factors seem to operate almost exclusively among young people and young marriages.