Making sense of illness: late-in-life migration as point of departure for elderly Iranian immigrants' explanatory models of illness

This article is based on data gathered through 60 qualitative interviews conducted within the realm of three research projects that have used culture-appropriate lenses to study the postmigration situation of late-in-life Iranian immigrants to Sweden. The findings gathered through these studies were interpreted against the backdrop that culturally appropriate nursing theories provide. This meant that it was, at times, these elders backgrounds as cultural others that were implicitly used to make sense of the various issues that were brought to the fore by these studies. The particular issue with which this article is concerned is the unusualness of these elders explanatory models of illness. Inspired by the concept definition of situation in the symbolic interactionist perspective and by the feeling that this perspective might bring about a different interpretation of the original findings regarding their understandings of illness and disease, we set out to conduct a secondary analysis of these elders explanatory models of illness. The findings presented in this article will show how the elderly Iranian immigrants interviewed in these three studies utilize the process of late in life migration as a point of reference for their understandings of what has caused the illnesses from which they suffered. Hereby we will suggest that the unusualness of their explanatory models of illness might be best understood if we focus on what they shared as immigrants (i.e., the fact that the process of late-in-life migration has made their culture obsolete) as opposed to what they shared as Iranians (i.e., their culture of origin).     

“Primary” Rationing of Health Services in Ageing Societies—A Normative Analysis

While most of the debate on rationing in health care focusses on the distribution of scarce medical resources among competing needs, which we propose to call secondary rationing, this paper is concerned with primary rationing, i.e., the conscious decision by society to limit the amount of resources devoted to a collectively financed health care system. Based upon a number of transparent normative criteria, we analyze whether primary rationing should be performed and, if so, what type should be chosen (hard vs. soft, explicit vs. implicit). Finally we discuss whether age should be used as a criterion in any systematic attempt at primary rationing of health care.     

Correlation between vibration-induced white finger and symptoms of upper and lower extremities in vibration syndrome

Summary The correlation was investigated between the frequency of attacks of vibration-induced white finger (VWF) and numbness or coldness of the fingers and legs in patients with vibration syndrome. Some 1687 patients with vibration syndrome were examined and of these 342 chain-saw operators and 277 rock-drill operators had no disease other than vibration snydrome. Then subjects were matched by age and period of treatment within three years. In the last analysis, 20 in the VWF almost everyday group or in the never group, and 40 in the occasionally group were selected from the chain-saw operators, and from the rock-drill operators 32 in the VWF everyday or the never group and 64 in the occasionally group. The present study showed that, with the frequency of VWF attacks, patients had a higher prevalence of coldness not only in the fingers but also in the legs. These findings suggest a correlation between the severity of circulatory disturbances of the upper extremities and that of the lower ones in patients with vibration syndrome. Further studies on circulatory disturbances in the leg are required.     

Muscle Learning Therapy—Efficacy of a Biofeedback Based Protocol in Treating Work-Related Upper Extremity Disorders

Work-related upper extremity disorders (WRUEDs) continue to present significant treatment and financial challenges to providers, employers, and insurers. This retrospective study reviews outcomes for 309 subjects who, between 1995 and 1999, were referred through the workers' compensation system for treatment of computer keyboard- and mouse-related WRUED injuries. The mean length of time from the recorded date of injury to the date of intake was 12.9 months. Subjects were offered a 12-visit course in muscle learning therapy (MLT). MLT is an operant conditioning program which uses surface electromyography (sEMG) to train injured workers to control their muscles during work activities. Patient response to therapy was obtained by a therapist-administered questionnaire during Visit 8 of 12. A group of 309 subjects, who had failed to respond to a previous course of therapy (typically physical therapy), reported significant improvements of pain in the neck, thorax, and upper extremities. Ninety six percent reported that they felt more in control, 86% reported feeling better overall, and 81% reported either working the same and feeling better or working and accomplishing more. This study provides preliminary support for this approach and provides justification for controlled clinical trials in the future.     

Heterosexual copulatory patterns in stumptail macaques (Macaca arctoides) and in other macaque species

A comparison of the mating behavior patterns of several macaque species reveals that the mating behavior of Macaca arctoidesexhibits several unique features. The laboratory groups of stumptail monkeys observed had exceptionally long single-mount copulations characterized by a large number of pelvic thrusts, a slow thrusting rate, and an unusually salient male orgasmic pattern (characterized by body rigidity followed by body spasms and a typical facial expression and vocalization). The frequency with which the copulation culminates in ejaculation is unusually high, and copulating stumptails generally manifest tieing in a genital lock after ejaculation. This research was supported in part by the Interdisciplinary Training Program, Langley Porter Neuropsychiatric Institute, University of California, San Francisco; by United States Public Health Service Training Grant No. 5-T1-MH-7082 from the National Institute of Public Health; and by Grant No. GS-31943X from the National Science Foundation to Dr. S. L. Washburn of the University of California at Berkeley, given for Primate Studies and Human Evolution.This paper was given as one part of the presentation prepared for the symposium Male and Female Sexual Behavior in Primate Societies, Fourth International Congress of Primatology, Portland, Oregon, August 1972. The first part was published as Male-Female, Female-Female, and Male-Male Sexual Behavior in the Stumptail Monkey, with Special Attention to the Female Orgasm,Archives of Sexual Behavior 3: 95–116, 1974.     

Media reviews

Of the three films reviewed in this issue, only the first, All Women Have Periods, deals with both areas of sexuality and disability. The second film, A Masturbatory Story, deals with sexuality but not disability. The third film, A Different Approach, deals with disability but not sexuality. The reason I have included the last two films are that A Masturbatory Story is one of the best, most permission giving films I have seen on the subject of masturbation and A Different Approach while focusing on employment of the disabled, is one of the most entertaining and effective films I have seen dealing with attitudes.     

Psychosocial stressors associated with Mexican migrant farmworkers in the midwest United States

Although estimates suggest that there are upwards of 5 million migrant farmworkers in the United States, scant research has explored the stressors associated with their lifestyle. Contrary to previous work, the present study directly explored migrant farmworkers' own perceptions of what is difficult in their lives. The purposes of the present study were to qualitatively explore, from a phenomenological standpoint, the stressors associated with living as a migrant farmworker in the Midwest United States; and to determine the stressors that were most strongly related to symptoms of anxiety and depression. The findings indicated that 18 stressors were commonly experienced by the migrant farmworkers and that the farmworkers experienced overall elevated levels of anxiety and depression. A number of stressors that were not previously reported in the literature were identified. The stressors of rigid work demands and poor housing conditions were significantly associated with higher levels of anxiety and low family income/living in poverty and rigid work demands were significantly associated with depression. Implications of findings and prevention strategies are discussed.     

Comparison of attitudes toward transsexuality and homosexuality

Attitudes toward transsexuality and homosexuality were compared in a sample of 318 university students. More people felt that homosexuality was wrong than felt that transsexuality was wrong. This difference in favor of transsexuality was more pronounced in female than in male respondents. In addition, more people rejected the notion that biological factors were responsible for homosexuality than was the case for transsexuality. General attitudes about the morality of transsexuality and homosexuality, however, were not mirrored in response to questions pertaining to job discrimination. To the contrary, male respondents, especially, were more inclined toward equal opportunity for homosexuals than for transsexuals. One hypothesis supported by this study was that homosexual denial and homophobia in some transsexuals may, in part, be a reflection of society's greater moral condemnation of homosexuality relative to transsexuality.     

Percutaneous absorption of N,N-dimethylformamide in humans

Summary Skin penetration fo N,N-dimethylformamide (DMF) liquid or vapour was studied in volunteers. Exposure to liquid DMF was performed in two ways: in a dipping experiment, one hand was dipped up to the wrist in DMF for 2–20 min, while in a patch experiment, 2 mmol DMF was applied to the skin and allowed to be absorbed completely. The period of exposure to DMF vapour (50 mg · m^–3) was 4 h. The DMF metabolites N-hydroxymethyl-N-methylformamide (MF), N-hydroxymethylformamide (F), and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC) were monitored in the urine. Liquid DMF was absorbed through the skin at a rate of 9.4 mg · cm^–2 · h^–1. Percutaneous absorption of DMF vapour depended strongly on ambient temperature and humidity and accounted for 13%–36% of totally excreted MF. The results suggest that skin absorption of liquid DMF is likely to contribute to occupational exposure substantially more than penetration of DMF vapour. The yield of metabolites after transdermal DMF absorption was only half of that seen after pulmonary absorption. Elimination of MF and F but not that of AMCC was delayed, which supports the contention that AMCC should be used instead of MF as the most suitable biomarker of DMF in cases where percutaneous intake can occur.     

“In vitro” measurements of spontaneous smooth muscle contractions: A screening method for “invivo” exposure

Conclusion The in vitro recording of spontaneous contractions was selected as a neuromuscular screening method for in vivo exposure to pollutants. The rate of contraction was determined by interval histogram measurements. The method was assessed for effects of age, sex, pH, Ca⁺⁺ concentration, temperature, and circadian rhythm. Male rats were shown to develop a slower rate of contraction with age. The rate of contraction was temperature and pH dependent. An effect was demonstrated for in vivo exposure to Baygon and Carbaryl at a level which did not produce overt symptoms.     

Financial “Rules” for Child and Youth Care Managers

Contemporary realities demand that child and youth care managers cast off their traditional avoidance of all things financial. This article offers a jargon-free list of twelve financial rules for thriving in turbulent times. Grounded in a concept of client-centered, results-based agency performance, rules include promoting an entrepreneurial spirit throughout the organization, destroying the taboo on open discussion of financial matters, slashing program development time, and spending lavishly on recruitment and universal staff training.     

Blood styrene concentrations in a “normal” population and in exposed workers 16 hours after the end of the workshift

Summary Blood styrene was measured by a gas chromatography-mass spectrometry method in 81 normal people and in 76 workers exposed to styrene. In the normal subjects, styrene was also tested in alveolar and environmental air. Styrene was found in nearly all (95%) blood samples. Average styrene levels in the normal subjects were 221 ng/1 in blood (Cb), 3 ng/1 in alveolar air (Ca) and 6 ng/1 in environmental air (Ci). Styrene levels did not differ significantly between smokers and non-smokers, 95% of values being below 512 ng/1 in Cb, 7 ng/1 in Ca and 15 ng/l in Ci. In workers with an average exposure to styrene of 204 g/l, at the end of the workshift, mean blood styrene concentration was 1211 g/l. In blood samples collected at the end of the Thursday shift, styrene levels were significantly higher (1590 g/1) than those found at the end of the Monday shift (1068 g/l. A similar difference was found in samples taken the morning after exposure (60 and 119 g/l, respectively). Significant correlations between blood and environmental styrene were found both at the end of the shift and the morning after exposure (r=0.61 and 0.41, respectively). In workers occupationally exposed to styrene, 16 h after the end of the workshift, blood styrene (94 g/l) was significantly higher than that found in the normal subjects (0.22 g/l). The half-life of blood styrene was 3.9 h.     

The evaluation of pornography: Effects of attitude and perceived physiological reaction

Twenty-three medical and 28 nonmedical male student Ss read four erotic prose passages and then rated each on obscenity, censorship, and four semantic differential evaluation scales. Ss were given varying levels of false (experimenter-controlled) GSR feedback for each stimulus passage, as well as different explanations of the significance of this arousal feedback. Four-way analyses of variance showed that low Stolerance of erotica, pedophelic passage content, and GSR feedback indicating physiological arousal resulted in passages being labeled as more obscene and unfavorable. Explanations to Ss that GSR feed-back indicated sexual arousal resulted in more favorable ratings by the medical Ss and interacted with passage type for the nonmedical Ss. Concurrently monitored heart rate was not significantly influenced by any of the experimental variables and was (with one marginal exception) uncorrelated with any of the dependent labeling variables. An earlier version of this article was presented at the XVIIth International Congress of Applied Psychology, Liege, Belgium, July 1971.     

Improving information systems in Europe: EURETHNET

The efforts of the European Commission to create a European Research Area in the field of biotechnology are accompanied by a growing demand for an ethical discourse. Cultural differences between the European Union's member states create a vital need to improve bioethical information structures in Europe so as to foster European bioethics discourses and to cope with ethical pluralism. Responding to the need for an increased European contribution to the international discussion on ethics in medicine and biotechnology, some of Europe's leading bioethics institutions have joined forces to establish the international network EURETHNET. 18 partners from nine European countries agreed to develop an information network and knowledge base in the field of ethics in medicine and biotechnology. This short communication displays the aims, scope and realisation of the network.This revised version was published online in October 2005 with corrections to the Cover Date.     

Levels of β-HCH,HCB, p,p′-DDE,p,p′-DDT and PCBs in human milk from a continental town in Croatia,Yugoslavia

Summary Concentrations of -HCH, HCB, p,p-DDE, p,p-DDT and PCBs were determined by gas chromatography in 50 human milk samples collected from the general population during 1981/1982 in a continental town in Croatia (Yugoslavia). The samples were collected between one and 22 weeks after delivery from mothers breast-feeding one child only. The mothers' age was 18 to 31 years, and they were nursing their first or second child. All 50 samples contained -HCH, HCB, p,p-DDE and PCBs, whereas p,p-DDT was present in 37 samples. The concentrations of -HCH, HCB, p,p-DDE, p,p-DDT and PCBs expressed on a whole milk basis were (median in g/kg): 11, 7.1, 67, 7.3 and 22 respectively, and expressed on a fat basis (median in mg/kg): 0.28, 0.21, 1.9, 0.18 and 0.62 respectively. The fat content was 3.7% (median). PCBs were present in a mixture containing penta-, hexa- and heptachlorobiphenyls.     

Fumigant contamination during large-scale food sampling for analysis

Incurred fumigants were determined from twenty-two food items before and after routine large-scale preparation of samples to see if these or similar kinds of chemicals were entering the samples during the preparation. This preparation includes making the samples table ready before compositing them for analysis. The following five fumigant residues were determined by gas chromatography (GC): carbon disulfide (CS₂), carbon tetrachloride (CCl₄), chloroform (CHCl₃), methyl chloroform (CH₃CCl₃), and tetrachloroethylene (or perchloroethylene, PCE). The number of residues determined from each sample ranged from none to four. The amounts determined varied significantly between the before and after portions from several samples. Four samples gained at least one new residue during the preparation. Six lost most of the residues determined from the original before portions, and 12 contained essentially the same residues before and after the preparation, although the amounts varied between the two portions. In samples where the variant residues were detected in both portions, five showed a tenfold or greater increase of CHCl₃ or CCl₄ and two showed a ten-fold or lesser decrease of CH₃CCl₃ or PCE in the after portions.     

Effect of instructions to simulate a back injury on torque reproducibility in an isometric lumbar extension task

The purpose of this study was to investigate the differences in test-retest reliability between maximal and simulated back injury efforts in an isometric lumbar extension task and to test the hypothesis that voluntary attempts to simulate a back injury would yield less consistent torque production than maximal efforts. Twenty subjects were asked to undergo lumbar extensor testing at seven different positions in a lumbar extension machine. Each subject was tested twice in a maximal effort condition and twice with instructions to simulate a back injury. The order of the conditions was counterbalanced across subjects so that half of the subjects performed the maximal effort tests first and half performed the simulated effort first. Results indicated high test-retest correlations at all angles in both conditions. There were no differences in test-retest reliability between effort conditions. Therapist ratings of consistency did not differ between conditions and therapists could not discriminate between conditions on the basis of effort consistency. In the simulated condition subjects produced reliable, submaximal torque plots consistent with previous data indicating similar reliability at submaximal levels. It was concluded that use of test-retest torque consistency as a measure of sincerity of effort is premature and may be misleading.     

Men's and women's reactions to sexually explicit films: A serendipitous finding

We proposed that men and women would be turned off by watching men and women like themselves engaged in sexual activity and turned on by watching someone of the opposite sex engaged in the same activity. We tested this hypothesis by showing college men and women eight films: films depicting male and female homosexuality, male and female masturbation, and males and females engaged in heterosexual intercourse. We assessed men and women's reactions via the Byrne-Sheffield (1965) Feeling Scale and Griffitt's (1975) Physiological Arousal Scale. We found support for our hypothesis. We also attempted to determine whether men and women differed in how easily they became aroused by sexually explicit films. We found that they did not.This research was supported, in part, by University of Wisconsin Graduate School funds and was conducted during the tenure of NIMH Grant MH 26681.     

Ultraviolet and volatility loss of herbicides

Herbicide 2,4-D formulated as a urea-type polymer was readily destroyed by long-wave uv (356-nm) irradiation, whereas conventional 2,4-D was more resistant. The opposite relationship was noted for polymeric and conventional formulations of dicamba. Polymerized 2,4-D was more resistant to thermal degradation (60°C) than non-polymerized formulations. Ultraviolet degradation of polymerized 2,4-D was eliminated by the incorporation of RYLEX-H and UVINUL D-50, industrial uv absorbers. Exposure of polymeric dicamba to 60°C heat, followed by trapping of the volatile component, indicated that 21 percent was lost by thermal degradation and 46.6 percent by volatilization. Comparable values for non-polymerized dicamba were 37.9 and 60.1 percent.     

The determinants of CABG patients' outcomes

This study examined the selfreported health status of 90 patients who had undergone Coronary Artery Bypass Grafting (CABG). Data were collected by the Short Form36 (SF36) instrument, administered twice at preoperative and postoperative periods. The reliability of the SF36 ranged from 0.68 to 0.93 in the analysis of preoperative and postoperative measures of health status. The CABG patients reported markedly lower health status on all eight SF36 dimensions at the preoperative period and considerable improvements on all dimensions at the postoperative period. The assessment of CABG patients' outcomes showed that perceived usefulness of the procedure contributed positively to their perceived health status when the effect of preoperative health status was controlled. Patients who perceived the CABG procedure as useful appeared to have more improved postoperative health status after the procedure.