Irritable bowel syndrome in Asia: Pathogenesis,natural history,epidemiology, and management

Historically, the epidemiology of gastrointestinal diseases in Asia was different from that in Western countries. Early studies suggested a low prevalence of irritable bowel syndrome (IBS) in Asia. As the diagnosis of IBS is symptom‐based and as symptom perception, expression, and interpretation are influenced by sociocultural perspectives including language, the presentation of IBS is expected to vary in different communities. Furthermore, the pathogenesis is multifactorial with psychosocial (stress, illness, behavior, and diet) and biological (infection, gut microbiota, and immune activation) variables interacting, and so, the present study can anticipate that the development of IBS will vary in different environments. In recognition of this aspect of functional gastrointestinal disorders, the recently published Rome IV documents have provided greater focus on cross‐cultural factors. In this review, the present study seeks to highlight Asian perspectives by identifying historical trends and recent publications from the region and comparing these with the observations from Western societies.     

Factor Structure of the Urdu Version of the Spence Children's Anxiety Scale in Pakistan

Spence Children's Anxiety Scale (SCAS) is one of the most commonly used self-report questionnaires to measure symptoms of anxiety disorders in adolescents. Despite its common use, studies that examine the psychometric properties of SCAS in Pakistan is lacking. Therefore, the purpose of this study was to examine the psychometric properties of the Urdu translated version of the SCAS among adolescents in Pakistan. A total of 1277 students (708 boys and 569 girls), aged 13 to17 years, who had been recruited from 13 schools in Rawalpindi, Pakistan participated in the study. The mean overall anxiety score was significantly higher in girls than males on all the SCAS subscales except for obsessive compulsive disorder. The internal consistency of the Urdu SCAS was good. Confirmatory factor analyses supported six separate factor structures. Results of the study are discussed with reference to the sociocultural milieu of Pakistan and culture sensitive conceptualization of anxiety and its subtypes.     

Type A Behavior and Job Performance: Some Suggestive Findings

Abstract

This study examined Type A and Type B differences in job performance, psychosomatic complaints, and career progression among white-collar employees (N = 218) in a field setting. Significant differences were found between Type A's and Type B's in quality of performance, effort exerted at the job, and psychosomatic complaints. Employees' cultural background and sex moderated some of the relationships observed in the study. Implications of the findings for future research on the topic are discussed.     

Beyond “Media Panics”:

This paper presents a critical review of the use of “moral panics” theory as a means of understanding public debates about children and media, and specifically of the notion of “media panics.” Following a brief presentation of the origins and key aspects of media panics theory, it focuses on six key issues that are at stake. It argues that there are some problems with the epistemology of media panics theory, with its account of intentionality, and with its claim to rationality. It further suggests that media panics theory tends to provide a “presentist” view of history, and a rather oversimplified account of cultural and generational politics; and that it neglects the positive positions that are also often rehearsed in public debate. The final section of the article provides brief discussions of two approaches that might provide productive alternatives to media panics theory: social constructionism and new cultural history.     

The Sustained,Positive Impact of a Native American Cultures and Health Course on Students’ Education and Practice-Related Choices

Objective. To encourage pharmacy students to elect education and practice opportunities in Native American communities, including careers with the Indian Health Service (IHS).Methods. Students in 2 elective courses were educated on various aspects of contemporary Native American life in urban and reservation environments, including cultural traditions, social and health-related challenges, health access disparities, and cultural approaches to health and wellness. The teachers were Native American leaders and healers primarily from Plains tribes, as well as non-Native American practitioners affiliated with IHS hospitals and tribal health facilities. Students kept reflective journals, and a subset spent 5 days immersed in a rural Navajo community where they lived and worked alongside IHS practitioners and Community Health Representatives.Results. Student engagement with IHS opportunities was tracked for 11 years. Of the 69 pharmacy students who completed the electives, 11 applied for a Junior Commissioned Officer Student Training and Externship Program (Jr. COSTEP) (8 accepted, 6 completed), 43 requested one or more IHS APPEs (43 accepted, 32 completed, 8 in progress), 17 applied for an IHS residency (1 pending, 8 accepted, 5 completed), and 5 became IHS Commissioned Corps officers. Five additional students accepted an IHS or tribal position, with 3 pursuing a USPHS commission.Conclusion. Since the first report on the impact of this elective experience was published, the course continues to meet its primary objective of promoting interest in IHS/tribal education experiences and pharmacy practice careers.     

A Complex Negotiation: Women's Experiences of Naming and Not Naming Premenstrual Distress in Couple Relationships

ABSTRACT

Recent research has demonstrated the importance of family relationships in women's experience of premenstrual changes, their construction of these changes as “PMS.” However, the discursive process by which women take up the subject position of “PMS” sufferer through the explicit naming of “PMS” to an intimate partner has received little research attention. Drawing on 60 individual interviews with Australian women, conducted between 2004 and 2006, we examined accounts of naming “PMS” in intimate relationships, women's explanations for naming or not naming, their experiences of their partner naming them as premenstrual. The analysis process identified an overarching theme of naming “PMS,” which was made up of three themes: naming to explain; “PMS” becoming the only explanation for distress; “PMS” as not a legitimate explanation for distress. The findings suggest that clinicians need to be aware of women's complex, often ambivalent, experiences of naming “PMS” within their relationships, when working with women, couples, seeking treatment or support for premenstrual distress.     

Transcultural skills content in a dental curriculum: a comparative study

Background: Australia has the highest proportion of immigrants in the world (24% of the population is overseas‐born, compared to 22% in New Zealand, 19% in Canada and 12% in the USA). In this context, dental students have become increasingly diverse in a milieu where patients are derived from increasingly diverse backgrounds. Aim: The study aims to analyse the degree to which transcultural and communication skills content is currently embedded in the medical, physiotherapy and dental curricula at a major Australian university. Materials and methods: Undergraduate dental, medical and physiotherapy curricula were compared and critically assessed. Researchers considered the amount of transcultural and communication skills content, the number of formal contact hours for each course and the number of teaching staff involved. In addition, 21 interviews were conducted with staff at the three schools, who were involved in the curriculum development process. Results: The medical and physiotherapy curricula had an explicit focus on transcultural and communication skills as a major and continuing element, delivered by teaching staff from a wide variety of academic and professional backgrounds. In contrast, the dental course showed an under‐representation of transcultural and communication skills content which was taught by a limited number of staff from the School of Dental Science. Conclusions: In marked contrast to medical and physiotherapy curricula, transcultural and communication skills content had a low formal profile in the dental curriculum. A curriculum review process may be a positive step towards the development of a new training curriculum giving higher priority to transcultural and communication skills to support more effective workforce development.     

The meaning and consequences of tuberculosis among Somali people in the United Kingdom

Aim. To ascertain the socio‐cultural meaning and consequences of tuberculosis among people of Somali origin living in the UK. Background. In countries where treatment has not been readily available, tuberculosis has become highly stigmatized. Research in Somalia has documented the stigma and social isolation associated with tuberculosis which acts as a powerful deterrent to sufferers acknowledging their illness. The Somali community in the UK is diverse and dynamic: little is known about how tuberculosis is understood, or how stigma is articulated and experienced post‐migration. Design. A focused ethnography was undertaken. Method. A total of 48 individual interviews were undertaken in 2008–2009 with community leaders, Somali community members and tuberculosis patients to explore the social meaning of tuberculosis and perceived consequences of the disease. Eight focus groups were undertaken involving 56 participants. Vignettes concerning tuberculosis were used to prompt discussion of community norms and socio‐cultural constructions of tuberculosis. Data were analysed using the ‘Framework’ approach. Findings. Most participants were familiar with tuberculosis, its characteristics and treatment. However, many participants held misconceptions about how the disease spread and its prognosis. Tuberculosis was perceived as a stigmatizing disease. Somalis with tuberculosis were considered likely to experience felt and enacted stigma with fear of discrimination in the form of social isolation influencing the extent to which people with tuberculosis disclosed their condition. Conclusion. Nurses should understand the socio‐cultural meaning and consequences of tuberculosis for Somalis to educate the community through public health initiatives and support patients and their families.