Japanese families who have lost children to cancer: a primary study.

By interviewing 13 Japanese families who have lost children to cancer within the past 3 years, the main caregiver for the sick child was found to always be the mother, and the mother was the leader whereas the father was a cooperator. These mothers tried to resolve their problems within the context of the relationship between the parents. This tendency relates to the structure of Japanese human relationships. The relationships between the mothers and fathers changed and became stronger or weaker. How fathers shared the mothers' burdens strongly influenced their relationships. To provide comprehensive care, health professionals must recognize the cultural influence on the family dynamics and the family's perceptions toward the illness.

Dietary survey of low-income, rural families in Iowa and North Carolina. I. Research procedures.

Methods used in assessing the dietary intake of selected low-income, rural families are described. The sample consisted of 668 families randomly selected from predetermined locations in Iowa and North Carolina. A 24-hr. recall method supplemented with food models was used in gathering data on family food intake. The nutritional "adequacy" of the family diets was then evaluated according to family composition and the 1968 Recommended Dietary Allowances. The adequacy of individual nutrients was also evaluated by the same criteria. Nutrients studied included: protein, calcium, iron, vitamin A, ascorbic acid, thiamin, and riboflavin. The selection of the method in relation to opinions of previous investigators is discussed.

Dietary survey of low-income, rural families in Iowa and North Carolina. II. Family distribution of dietary adequacy.

Distribution patterns of Iowa and North Carolina families for dietary adequacy at various income levels were compared according to: (a) two family dietary standards, based on the 1968 Recommended Dietary Allowance and the Ten-State Nutrition Survey dietary standards, and (b) two income standards, family income and per capita income. A 24-hr. recall method was used to collect the dietary data. Nutrients studied included: protein, calcium, iron, vitamin A, ascorbic acid, thiamin, and riboflavin. Clear differences emerged in family distribution patterns by the two dietary standards and by the two income standards. Comparison of family distribution patterns for dietary intake by the two standards showed that percentages of families with poor nutrient intakes were lower by Ten-State evaluation than for the recommended allowance evaluation, except for protein and iron. For example, the percentage of families with poor calcium intakes, by Ten-State criteria, was approximately half that measured by the recommended allowances. While, according to the latter, calcium was the most limiting nutrient in many family diets, vitamin A was most limiting by Ten-State evaluation. The proportions of families with poor ascorbic acid, thiamin, and riboflavin intakes were also lower by Ten-State standards. While the iron adequacy remained approximately the same by both dietary standards, the percentage of families with poor protein intakes was higher by the Ten-State criteria. A higher percentage of families at each income level had fair and good diets by Ten-State comparison. Family distribution patterns for intakes of individual nutrients at various family income levels demonstrated a positive relationship between nutritional intake and income. Proportions of families with poor nutrient intakes according to per capita income tended to increase with the income level. For both income standards, the percentages of families with good and fair diets in the total family sample gradually increased with income. Percentages of Iowa families with fair and good diets at various income levels were, in general, higher than those of North Carolina families. The lowest and the highest percentages of families with poor diets of two population groups were higher for per capita income distribution than for family income distribution.

Dietary survey of low-income, rural families in Iowa and North Carolina. III. Contribution of food groups to nutrients.

Percentage contributions of specific food groups indicated in the Basic 4 to protein, calcium, vitamin A, and ascorbic acid in one day's diets of thirty-five Iowa families and twenty-five North Carolina families are reported. All members of the families ate all meals at home. Their diets met or exceeded two-thirds of the 1968 Recommended Dietary Allowances for seven nutrients. Data were collected by the 24-hr. recall method. While the percentage contribution of the meat group to protein intake of the North Carolina families ranged from zero to 84 per cent, that of the Iowa group was from 35 to 85 per cent. The range for the percentage contribution of the milk group to calcium intake of North Carolina families was similar; however, in the Iowa group the range was from 2 to 97 per cent. The vitamin A-rich fruit and vegetable group contributed from zero to 99 per cent for the North Carolina families of vitamin A intake and from zero to 88 per cent for the Iowa group. Ascorbic acid-rich fruits and vegetables contributed from zero to 100 per cent of the ascorbic acid intake of the Iowa group and from zero to 95 per cent in North Carolina families. The results support the argument that the exclusive use of the "Daily Food Guide" or the "Basic 4" to assess nutritional intake of diets may produce biased in formation.