972 resultados para Marriage counseling


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by Louis M. Epstein

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Prostate cancer (CaP) is the most commonly diagnosed malignancy in males in the Western world with one in six males diagnosed in their lifetime. Current clinical prognostication groupings use pathologic Gleason score, pre-treatment prostatic-specific antigen and Union for International Cancer Control-TNM staging to place patients with localized CaP into low-, intermediate- and high-risk categories. These categories represent an increasing risk of biochemical failure and CaP-specific mortality rates, they also reflect the need for increasing treatment intensity and justification for increased side effects. In this article, we point out that 30-50% of patients will still fail image-guided radiotherapy or surgery despite the judicious use of clinical risk categories owing to interpatient heterogeneity in treatment response. To improve treatment individualization, better predictors of prognosis and radiotherapy treatment response are needed to triage patients to bespoke and intensified CaP treatment protocols. These should include the use of pre-treatment genomic tests based on DNA or RNA indices and/or assays that reflect cancer metabolism, such as hypoxia assays, to define patient-specific CaP progression and aggression. More importantly, it is argued that these novel prognostic assays could be even more useful if combined together to drive forward precision cancer medicine for localized CaP.

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Lake Victoria is Africa’s single most important source of inland fishery production. After it was initially fished down in the first half of the 20th century, Lake Victoria became home to a series of introduced food fishes, culminating in the eventual demographic dominance of the Nile perch, Lates niloticus. Simultaneously with the changes in fish stocks, Lake Victoria experienced dramatic changes in its ecology. The lake fishery during most of the 20th century was a multispecies fishery resting on a diverse lake ecosystem, in which native food fishes were targeted. The lake ended the century with a much more productive fishery, but one in which three species — two of them introduced — made up the majority of the catch. Although many fish stocks in Lake Victoria had declined before the expansion of the Nile perch population, a dramatic increase in the population size of Nile perch in the 1980s roughly coincided with the drastic decline or disappearance of many indigenous species. Now, two decades after the rise of Nile perch in Lake Victoria, this species has shown signs of being overfished, and some of the native species that were in retreat — or even thought extinct — are now reemerging. Data on the resurgence of the indigenous species suggest that heavy fishing of Nile perch may enhance biodiversity; this has spawned renewed interest in management options that promote both fishery sustainability and biodiversity conservation.

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While the negative effects of divorce on well-being are well documented in research literature, the large individual differences in psychological adaptation over time are still not well understood. This is especially the case for marital breakup after long-term marriage, which is still a neglected research topic. Against this background, the aim of the present contribution is to shed light on the various trajectories of psychological adaptation to marital breakup after a long-term relationship. Data stem from a longitudinal survey study, which is part of the Swiss National Centre of Competence in Research ‘LIVES – Overcoming vulnerability: life course perspectives’ (funded by the Swiss National Science Foundation). Our analyses are based on results of an exploratory latent profile analysis performed at the first assessment in 2012 among 308 divorced participants aged 45 – 65 years, who divorced after an average of 25 years of marriage (Perrig-Chiello, Hutchison, & Morselli, 2014). Five different groups regarding psychological adaptation to marital breakup (i.e. life satisfaction, depression, hopelessness, subjective health, and mourning) were identified. They were composed of two larger groups of individuals that adapted quite well or very well (“average copers”, n=151 and “resilients”, n=90) and of three smaller groups with major difficulties to adjust to the new situation (“vulnerables”, n= 18; “malcontens”, n= 37 and “resigned ones”, n=12). Clusters differed statistically significant regarding personality variables, time since separation, current relationship status, and financial situation. In the present contribution, we want to investigate the course of adaptation of the five classes two years later by using latent transition analysis. Furthermore, we aim to examine which variables in terms of personality, relationship status, variables of the context of the separation and socio-demographic variables are crucial for change or stability in levels of adaptation in the different classes. The evaluation of the trajectories of adaptation to this critical life event and the identification of variables that enhance the adaptation over time is essential for developing more differentiated measures in counselling as well as intervention techniques in clinical and social services.

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Background: Marital dissolution is known to be among the most stressful life events with long- reaching negative consequences on individuals’ lives. A limitation in research to date is that most studies have focused on the impact of marital disruption on well-being outcomes in younger adults. Furthermore, although population-based studies on divorce document a broad range of negative effects, more fine-grained analyses reveal a large heterogeneity in people’s adjustment, which is still not well understood. Objective: To explore trajectories of psychological adaptation to marital breakup after a long-term marriage, and to examine variables accounting for recovery or chronicity in terms of intrapersonal resources (personality, trait resilience, personal growth), relationship variables (satisfaction with ex- relationship, length of marriage, time since divorce) and socio-demographic variables (age, gender, financial situation). Methods: Latent transition analysis is used to examine the course of psychological adaptation (i.e., depressive symptoms, life satisfaction, hopelessness, mourning and subjective health) to divorce over two years among five profiles of 308 divorcees (mean age: 55.6 years; average duration of former marriage: 23.62 years): Two larger groups of individuals, the one which adapted very well (‘resilients’, 29%), the other quite well (‘average copers’, 49%), and three groups with major difficulties (‘vulnerables’, 6%; ‘malcontents’, 12%; and ‘resigned’, 4%). In a second step the differences among transition patterns were explored on the basis of the distal variables (i.e., intrapersonal resources, relationship variables, socio-demographics). Results: Although the probability of upward changes was higher for those individuals with lower adaptation at time 1, only a small number of individuals made an upward change from the maladapted to the well-adapted groups throughout the two years. The groups of copers and resilients remained stable in their psychological adaption. The most consistent results related to upward changes were intrapersonal resources, namely the NEO personality traits and trait resilience. Conclusion: The majority of individuals divorcing after a long-term marriage adapt successfully over time. Adaptation trajectories depend primarily on intrapersonal resources. However, a minority of divorcees exhibit enduring difficulties. Knowledge about the diversity of these trajectories of vulnerability could be of great help for designing psychological interventions to better tackle this critical life event.

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This thesis explores how LGBT marriage activists and lawyers have employed a racial interpretation of due process and equal protection in recent same-sex marriage litigation. Special attention is paid to the Supreme Court's opinion in Loving v. Virginia, the landmark case that declared anti-miscegenation laws unconstitutional. By exploring the use of racial precedent in same-sex marriage litigation and its treatment in state court cases, this thesis critiques the racial interpretation of due process and equal protection that became the basis for LGBT marriage briefs and litigation, and attempts to answer the question of whether a racial interpretation of due process and equal protection is an appropriate model for same-sex marriage litigation both constitutionally and strategically. The existing scholarly literature fails to explore how this issue has been treated in case briefs, which are very important elements in any legal proceeding. I will argue that through an analysis of recent state court briefs in Massachusetts and Connecticut, Loving acts as logical precedent for the legalization of same-sex marriage. I also find, more significantly, that although this racial interpretation of due process and equal protection represented by Loving can be seen as an appropriate model for same-sex marriage litigation constitutionally, questions remain about its strategic effectiveness, as LGBT lawyers have moved away from race in some arguments in these briefs. Indeed, a racial interpretation of Due Process and Equal Protection doctrine imposes certain limits on same-sex marriage litigation, of which we are warned by some Critical Race theorists, Latino Critical Legal theorists, and other scholars. In order to fully incorporate a discussion of race into the argument for legalizing same-sex marriage, the dangers posed by the black/white binary of race relations must first be overcome.

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Despite a longstanding belief that education importantly affects the process of immigrant assimilation, little is known about the relative importance of different mechanisms linking these two processes. This paper explores this issue through an examination of the effects of human capital on one dimension of assimilation, immigrant intermarriage. I argue that there are three primary mechanisms through which human capital affects the probability of intermarriage. First, human capital may make immigrants better able to adapt to the native culture thereby making it easier to share a household with a native. Second, it may raise the likelihood that immigrants leave ethnic enclaves, thereby decreasing the opportunity to meet potential spouses of the same ethnicity. Finally, assortative matching on education in the marriage market suggests that immigrants may be willing to trade similarities in ethnicity for similarities in education when evaluating potential spouses. Using a simple spouse-search model, I first derive an identification strategy for differentiating the cultural adaptability effect from the assortative matching effect, and then I obtain empirical estimates of their relative importance while controlling for the enclave effect. Using U.S. Census data, I find that assortative matching on education is the most important avenue through which human capital affects the probability of intermarriage. Further support for the model is provided by deriving and testing some of its additional implications.

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Authors of experimental, empirical, theoretical and computational studies of two-sided matching markets have recognized the importance of correlated preferences. We develop a general method for the study of the effect of correlation of preferences on the outcomes generated by two-sided matching mechanisms. We then illustrate our method by using it to quantify the effect of correlation of preferences on satisfaction with the men-propose Gale-Shapley matching for a simple one-to-one matching problem.

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Men's and women's preferences are intercorrelated to the extent that men rank highly those women who rank them highly. Intercorrelation plays an important but overlooked role in determining outcomes of matching mechanisms. We study via simulation the effect of intercorrelated preferences on men's and women's aggregate satisfaction with the outcome of the Gale-Shapley matching mechanism. We conclude with an application of our results to the student admission matching problem.

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Jozef Israels

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