Rationalizing self-defeating behaviors: Theory and evidence

Why do individuals engage in self-defeating behaviors like self-harm, addiction, and risky sexual behaviors? Why do they experience the apathy of depression or inaction when trapped by multiple competing problems? We propose a framework for explaining these and other related behaviors based on the insight that individuals can only experience a limited number of latent stimuli to which they are exposed. We conduct an experiment to test this model and find that more than two thirds of the subjects behave consistent with our theoretical framework.     

Children's Ways of Experiencing Peer Interaction

Educational practice in age integrated child groups rests on the assumption that children learn from their peers. The benefits of age integrated teaching is to enhance the value of heterogeneity in child groups. The fact that children are different from each other with different experiences is seen as an asset, which both children and teachers can benefit from. 22 children in a school class with children of mixed age; ranging from 7-9 years, were interviewed about their conceptions of peer interaction. How do children conceive peer collaboration, and what does it mean to children to teach someone something? A phenomenographic research approach is being used to discern the variation in ways of thinking about how children do when they teach someone something, and how they conceive peer collaboration at school. Children are conscious about the fact that they are able to teach their peers, and they can express this in different ways. Children also shift in their roles as “teacher” and “learner”. In some examples it is the “teacher” who plays the active role, in others it is the “learner” who has to be active by imitating the model/teacher.     

Venereophobia

Some patients refuse to accept that they do not have a sexually transmitted disease despite vigorous reassurances. Why do they behave in this fashion and how can they be recognized?     

Writing a case report: an editor's eye view

'That was a nice presentation. Why not write it up for a journal?' With such words a thousand case reports are born. But they are like birds tossed over a stormy ocean: only a few gain a foothold in the rigging of passing ships--for the rest, oblivion. So, how do you persuade an editor to accept your wonderful case report? Here are some reflections from the editor's standpoint.     

Building a Comprehensive School-based Drug/Alcohol Prevention Program

Concerned educators trying to help students who abuse alcohol and drugs want assurances that the process they use does work. They ask, “How are we doing? Are we making a difference in the lives of our students?”

Unfortunately, there often is no one person or group they can call on for a quick answer. The district personnel directing the prevention and intervention program, as well as trained outsiders, struggle to determine whether progress is being made. Self-made assessment tools can become subjective and selective.

Schools are struggling to find effective, cost-efficient programs that reduce drug use. Building a comprehensive Drug/Alcohol program is one of the most important tasks administrators can face.     

Coping and complaining: Attachment and the language of disease. Simon R Wilkinson. (318 pages, {pound}16.99.) Brunner-Routledge, 2003. ISBN 1-58391-170-7.

Why do some patients remain the picture of calm, despite thegravest of prognoses? Why do others rap at my door with theslightest snuffle? Why do patients with multiple unexplainedsymptoms, who use outpatient facilities nine times more thanaverage still retain their complaints and come back for more,whilst complaining     

A BETR way to track toxic pollutants

Why are chemicals that have been banned for over a decade still being detected in the environment? How is it that chemicals and other pollutants such as particulate matter turn up hundreds or even thousands of miles from their sources? These are just two of the questions that a team of American and Canadian scientists hope will be answered using a model they have developed to track pollutants across North America. In the short term, the model's developers are concentrating on using it to assess rates of exposure from food sources, but they hope to expand the model to include global data, a step they hope will help policy makers better understand the consequences of pollution.     

The mystery of altruism and transcultural nursing

Why do some individuals choose the professions they do? Is it for altruistic reasons? This article examines this question from the standpoints of sociobiology, evolutionary biology, game theory, and memetics. Implications for transcultural nursing are included. The Giger-Davidhizar Transcultural Assessment Model is presented as a nursing model and might explain altruism even beyond other models. An overview of the Giger-Davidhizar Transcultural Assessment Model is included.     

Confrontation in the climacteric.

Why is an increasing number of women dissatisfied with their doctors' help in their climacteric? Why do so many object to hormone replacement therapy (HRT)? Why do they generally feel it is not 'natural'? Though many object to getting old, want to continue flaunting their 'eternal youth', many more, women and men, embrace retirement, wish to rest and slow down. There is no mistaking these extremes, for while the first grasp at every possible treatment, the last are but seldom medically seen. It is the middle majority, their demands, censure, disapproval, even open confrontation with those who try to help them which is difficult to understand. This paper briefly reviews the manner in which Western climacteric women have, during two hundred, but mainly last fifty, years confronted their world: their protests at societal attitudes, their private marital conflicts, their demands of doctors and, finally, their present criticism of them. It also pays detailed attention to the key concept of 'natural' treatment. Finally it suggests that much of present climacteric confrontation is a displacement activity, born of concurrent conflicting desires for both youth and retirement, rather than aimed specifically at doctors.     

FOOD INSPECTION AND FOOD IN RELATION TO PUBLIC HEALTH

"Why should not cities solve their milk problems as they have those of water supply?" queries Dr. Koehler. From the vital statistics of a metropolis he asserts relations between food inspection and typhoid and between pasteurization and infant mortality. He considers accurate information on dietetics a necessary health measure.     

The teacher's lap – a site of emotional well-being for the younger children in day-care groups

This study focuses on a particular relationship between teachers and one- to three-year-old children: the child in the teacher's lap. When, in what situations, does this happen? Who are the children in the teacher's lap? Why are they there? How do children express emotional well-being when in the teacher's lap? Relational, sociocultural and revised attachment approaches to emotional well-being supplied the theoretical framework of the study. Data were collected by ethnographic methods and analysed qualitatively. Two day-care groups in Finland participated. For most of the day, at least one child was in a teacher's lap. The teacher's lap signified, for example, not only consolation and confidence but also delight. Furthermore, for the children, it was a contested site for gaining teacher attention and displaying power. The teachers also enjoyed this affective bond with the children, while having a child in their lap also had practical value, for example, sometimes it guaranteed undisturbed play for the other children.     

Togetherness — A Manifestation of Day Care Life

This article discusses togetherness in the day care centre. In what way and in which situations is togetherness expressed among children? “What is the impact of adults on the rise and development of togetherness?” Answers to these questions were sought by making use of observations carried out in a cooperative Nordic study of the quality of children's lives in Danish, Finnish and Swedish day care centres. The data were collected by observing five-year-old children during their daily activities in seven day care centres. Attention was paid to relations between the children and adults as well as to the objects — in the sense of contents and objectives of ongoing activities. What do individual children do and why do they do it? “What is the object of the educator and the whole group? In what ways do the children and the educators participate in joint activity?” In this article, only the objects of activities and the relations connected with the theme of togetherness are taken into consideration. The study describes how the general object of togetherness has to do with positive emotional relations. This poses an interesting question: How, do positive emotional relations and togetherness, in turn, contribute to children's development and learning? By means of this study, only some hypotheses can be made: togetherness might be an important factor in building a real community of learners, not only in the day care centre but perhaps also in other educational settings.     

FOOD INSPECTION AND FOOD IN RELATION TO PUBLIC HEALTH

“Why should not cities solve their milk problems as they have those of water supply?” queries Dr. Koehler. From the vital statistics of a metropolis he asserts relations between food inspection and typhoid and between pasteurization and infant mortality. He considers accurate information on dietetics a necessary health measure.     

Reproduction trends and the emergence of moral panic

Are we witnessing a moral panic or a moral evaluation in the responses to the new reproductive technologies? Locating women in reproductive technology is a particularly powerful way into a discussion of values and consequences, intended or unintended. Twelve areas are isolated for discussion beginning with issues of definition and location: What is reproductive and genetic engineering? and How does human reproduction fit into bio-technological developments generally? Next issues are raised about how the new developments are being shaped ideologically and how they are being promoted by the state. A series of legal issues affecting women, men, children, embryos and fetuses follow. The focus then shifts to the way women are ideologically constructed: Why is there an assumption that woman = mother, and mother = heterosexual married or stable cohabiting woman?--and socially controlled: Why assume technological change in human reproductive processes means the basic subordination of women to men will not alter? The usefulness of the new technologies in relieving involuntary childlessness is then queried which leads on to a questioning of whether these developments are qualitatively different from other technologies used in human reproduction. Futuristic concerns such as the importance of the male pregnancy and the social consequences of fully medicalising human reproduction are raised. The last area to be considered is protest by women and suggested alternative approaches to increase the social visibility and recognition of the needs and interest of women in the current and potential use of the new medical and scientific developments.     

Lessons from community participation in health programmes

Although primary health care emphasizes community participationand many health care programmes attempt to develop participation,good analysis of these developments is still rare. This paper,based on a review of about 200 case studies, examines some ofthe lessons for planners which are emerging from experiencesof the last decade. These lessons focus on the problems of definingthe term ‘community participation’, of gaining andsustaining broad-based community participation, of failing torecognize the political implications of the concept and of attemptingto develop a management model of community participation forhealth. Based on these lessons, a planning framework is suggestedthat seeks individual programme answers to three questions:‘Why participation?’, ‘Who participates?’,‘How do they participate?’. The answers to thesequestions will help to define a programme's objectives and tomonitor and evaluate its development.     

Leadership in turbulent times is spiritual

In the past decade, two formerly estranged domains, spirituality and work, have been increasingly linked. Why has this happened? This articles posits that this strange union is an unavoidable consequence of living in a turbulent time. As our world grows more chaotic and unpredictable, leaders must respond to questions that have historically only been answered through spiritual traditions: How do I cope with incertainty? How do I help others find meaning in their lives? What are my values? How can I act with courage and integrity? Leaders also play a key role in helping people recognize that life is cyclical, unpredictable, and unstable and that they must engage it as such. This is well-explored in spiritual traditions, but not in traditional management literature. Several organizational and personal practices are offered as simple ways to develop leadership capacity for leading in turbulence.     

Marriage of convenience. As they adapt to reform, insurers court historic adversaries: physician practices

As reform's changes continue to ripple through the marketplace, insurers are moving to buy physician practices. Why would docs agree to such deals? Some who've made the move say they see it as a strategic decision. "We wanted to partner with a player with lots of market share and lots of markets. We were little and we were in need of a bigger playground to play in," says Alan Hoops, left, of CareMore.     

Challenging the stereotypes: men, withdrawal, and reproductive health in Lebanon

In Lebanon, coitus interruptus or withdrawal remains a widely practiced method of family planning. Our research sought to understand the role of men in reproductive health in Lebanon by focusing on this common practice. Our main questions were: Why is it that the practice persists when more effective modern methods of family planning are available? How is the decision taken to practice withdrawal? When is withdrawal practiced and with whom? And, finally, does the practice of withdrawal affect sexual pleasure and the sexual relationship more generally?To answer these questions, we embarked on a small exploratory study using in-depth interviews with 16 open-ended questions. We found that the most important reason for the continuing practice of withdrawal is fear of side effects from other methods. Men and women expect pleasure and fulfillment in sexual relations, but they are willing to limit their pleasure to limit their fertility by means they consider safe. No one prototypical practice of withdrawal seems to exist, and this may explain whether or not the method fails to prevent pregnancy.     

Advance directives: overcoming reluctance and getting them done

Why do less than 10% of healthy adults have them? Why do less than 20% of frail elders have them? If we examine the incentives and the disincentives adults feel to complete advance directives, we can focus our educational efforts for maximal effect and get this important work done.