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The impact of government economic restraint on mental health services in Canada.

The author discusses what he considers a fundamental change in the political, economic and social value system since the mid-1970s, and how this change is reflected in three trends of particular relevance to mental health services: the growing emphasis on the "residual" model of welfare; the "privatization" of mental health service delivery; and the tolerance of high levels of long-term unemployment. He criticizes the assumptions underlying these trends, and emphasizes that the choice of social and economic priorities is ultimately based on values rather than on empirical data. Accordingly, he argues for broad societal participation in the choice of priorities.

Canada↗

Freshwater as shared between society and ecosystems: from divided approaches to integrated challenges.

The paper has its focus on water's key functions behind ecosystem dynamics and the water-related balancing involved in a catchment-based ecosystem approach. A conceptual framework is being developed to address fundamental trade-offs between humans and ecosystems. This is done by paying attention to society's unavoidable landscape modifications and their unavoidable ecological effects mediated by water processes. Because the coevolution of societal and environmental processes indicates resonance rather than a cause-effect relationship, humanity will have to learn to live with change while securing ecosystem resilience. In view of the partial incompatibility of the social imperative of the millennium goals and its environmental sustainability goal, human activities and ecosystems have to be orchestrated for compatibility. To this end a catchment-based approach has to be taken by integrating water, land use and ecosystems. It is being suggested that ecosystem protection has to be thought of in two scales: site-specific biotic landscape components to be protected for their social value, and a catchment-based ecosystem approach to secure sustainable supply of crucial ecosystem goods and services on which social and economic development depends.

Conservation of Natural Resources↗

Justice and fairness in the Kennedy Krieger Institute lead paint study: the ethics of public health research on less expensive, less effective interventions.

The Kennedy Krieger lead paint study stirred controversial questions about whether research designed to develop less expensive interventions that are not as effective as existing treatments can be ethically warranted. Critics questioned the social value of such research and alleged that it sanctions a double standard, exploits participants, and is complicit in perpetuating the social injustice. In response, we demonstrate the propriety of conducting research on interventions that can be extended to the population in need by stipulating the limited conditions in which it is ethically warranted and providing fair terms of participation. We contend that the failure to conduct such research causes greater harm, because it deprives disadvantaged populations of the benefits of imminent incremental improvements in their health conditions.

Baltimore↗

Bosnian refugees and the stressors of exile: a narrative study.

The authors used semistructured interviews to examine exile-related stressors affecting a sample of 28 adult Bosnian refugees in Chicago. The interviews covered 3 areas: life in prewar Bosnia, the journey of exile, and, most centrally, life in Chicago. Primary sources of exile-related distress included social isolation and the loss of community, separation from family members, the loss of important life projects, a lack of environmental mastery, poverty and related stressors such as inadequate housing, and the loss of valued social roles. The implications of these findings for mental health interventions with refugees are considered, and the value of narrative methods in research with refugee communities is discussed.

Adaptation, Psychological↗

Gender perspectives and quality of care in underdeveloped countries: disease, gender and contextuality.

There is indisputable evidence that health indices for women are far worse than those for men, yet women have limited access to health resources. Numerous reasons have been cited for the poor health of women, and include legal constraints to owning property, the lack of participation in the planning process, preferential treatment for boys, and social values, norms and customs. Most of the research on women while adequately documenting these facts, fails to contextualize them in a social, economic and political setting which is often responsible for the problems in the first place. This serious shortcoming negates the efficacy of the well-intentioned and well-meaning solutions in redressing the gender balance. Unless one examines the structural factors which actually cause disease, both in men and women in underdeveloped countries, solutions will be ineffective. The paper also highlights the important fact that there are many more similarities between men and women of the same social class than is appreciated, similarities which are possibly greater than those between the same gender across different social classes.

Culture↗

Body mass index and some psychopathological symptoms in open community nuns.

This article examines the connections between body weight and psychopathological symptoms in a religious community. The Symptom Checklist 90-Revised was administered to 34 nuns, whose body mass index (BMI) values significantly correlated with hostility (r=0.46, p<0.01). These findings support the idea that people living in open religious communities share social values regarding weight and body size, and reveal high levels of psychological discomfort when body weight increases.

Adolescent↗

Migrants and the meaning of parenthood: involuntary childless Turkish migrants in The Netherlands.

BACKGROUND: Parenthood motives of infertile Turkish migrant men and women in The Netherlands are compared with those of infertile Dutch men and women. Additionally, the question of whether the importance of various parenthood motives of Turkish migrants are related to the degree of adaptation to the Dutch culture was investigated. METHODS: Questionnaires were administered to 58 involuntary childless Turkish migrant men and women and 162 involuntary childless Dutch men and women. RESULTS: Individual parenthood motives were most important to both Turkish migrant and Dutch men and women. While social motives were quite important to Turkish migrants, they were unimportant to Dutch men and women. Four aspects of adaptation (norms and values, social integration, skills, absence of feelings of loss related to migration) were negatively related to the importance of social parenthood motives for Turkish migrant women. For Turkish migrant men two aspects of adaptation (traditions and absence of loss) were negatively related to the importance of social parenthood motives. CONCLUSION: Turkish migrant and Dutch men and women differ in the importance of social motives. However, Turkish migrants who are more adapted to the Dutch culture give less importance to social parenthood motives.

Adaptation, Psychological↗

"Properly disposed of": a history of embryo disposal and the changing claims on fetal remains.

This paper explores recent controversies concerning the disposal of embryonic and fetal remains in order to ask how such remains came to be classified as "medical waste." Based on archival research into the social history of human embryo collecting in Baltimore, Maryland, in the early 20th century, I argue that the classification of embryos and fetal remains as medical waste can be traced to a pragmatic alliance between embryologists and state functionaries. Embryologists relied on the state to assist them in acquiring thousands of human embryo remains for scientific study, while state authorities relied on embryologists to provide authoritative knowledge that could be used to facilitate state control over nascent citizens. This alliance contributed to the development of an "embryological worldview," in which human embryos were cast as objective biological "specimens" of use only to embryologists. This exclusive view of the social value of embryos and fetal tissue is now being challenged as other constituencies claim jurisdiction over the remains in order to advance diverse social agendas.

Burial↗

Transition to manhood: effects of the Great Depression on male youth.

This paper has been an exploration into the social and psychological problems associated with male youth growing up in the 1930s. By first defining and understanding the major transitions to adulthood--exiting from school, leaving the house of origin, entering the labor force, getting married, and establishing a separate household--it was then possible to explore how these transitions were affected by social, economic, and political factors in the Depression. It was also possible to examine how these factors affected the search for identify and role development in male youth. The historical study of adolescence in America has concentrated primarily on demographic data and observable behavior. Likewise, psychological studies on adolescence have concentrated on the recent past, and have tended to look at the individual rather than the relationship between the individual and/or cohort, and the social values and mores as well as economic and political conditions of the period under study. Youth culture, which can be defined as a socially recognized and institutionalized adolescence, has undergone dramatic change since the late 19th century. The transition to adulthood has not been a smooth evolution, as this paper suggests. Rather, the transition has been affected by societal conditions. Future historical research of American youth should look more closely at the differences between the sexes, as well as the influence of socioeconomic status, ethnic background, environment, and so forth. For example, a possible study might look at social and psychological problems of male youth coming of age during World War II--or Korea or Vietnam--and how the transition to adulthood was affected during these times. Other questions that lend themselves to adolescent research include the following: How have youth been affected by the economic climate (i.e., prolonged during affluent times, shortened during hard times)? What has been the historical trend in the transition to adulthood, and what have been the corresponding social and psychological adjustments? How has the youth culture influenced the adolescent experience in American society? Finally, an area that invites further research--especially with the growing interest in women's studies and the new concern with the male role in society--is the different role expectations of male and female youth, and how these expectations relate to the transition process.

Adolescent↗

Does America spend enough on addiction treatment? Results from public opinion surveys.

Addiction treatment is often misunderstood and underappreciated in the United States. Although a large body of literature clearly demonstrates the clinical and economic benefits of addiction treatment for many clients and in most settings, the general public has a somewhat ambivalent attitude toward treatment expansion and taxpayer financing. A potential reason for this disconnect between economic evidence and public opinion is a weak identification with the need for, or the success of, addiction treatment for those individuals without a substance abuse problem themselves or in members of their family. Alternatively, addiction treatment stakeholders may be delivering an ineffective or misdirected message about the social value of this industry. This article explores these and other potential explanations for the paradoxically low placement of the addiction treatment industry among other socially important institutions in the United States. Although none of the explanations advanced in this article has been scientifically tested or verified, it is hoped that the historical inquiry and information provided herein will offer practical strategies for the stability and growth of the addiction treatment industry.

Adult↗

[What is a disease?].

The concept of disease is more complex than it may seem. Disease is both a natural category and a social construction. Medical anthropology distinguishes between three realities under the different words defining "disease": the biological abnormalities (disease), the subjective experience of altered physical state (illness), and the process of socialization of pathological episodes (sickness). The constructivist perspective of the sociology of science shows that scientific knowledge reflects cultural beliefs and social values. A diagnosis is "constructed" in the interaction of patients and physicians, and of their respective representations of disease, in a given historical and social contex. The example of fibromyalgia has been chosen to illustrate this social construction of diagnostic categories.

Anthropology↗

Silencing the Singer. Antibioethics in Germany.

"Die Gedanken sind frei," in the words of the old song. But in Germany, thoughts are no longer free. Peter Singer, the "death ethicist," has become a special target for activists attempting to silence bioethical debate in Germany. In the context of the trauma inflicted by National Socialism, a profound unease over issues at the end of life is accompanied by an insistence that these issues are not to be discussed.

Abortion, Legal↗

[Social adjustment and depression: value of the SAS-SR (Social Adjustment Scale Self-Report)].

The Social Adjustment Scale Self-Report (SAS-SR) is a simple and inexpensive method, which allows the routine assessment of the patient's social adjustment, especially in the case of depression. Compared with other scales based on an interview with the patient, the SAS-SR is more sensitive to change in the patient's clinical status. The SAS-SR is a useful method as part of the detection of even mild depressions, regular aftercare evaluation of out-patients or as an outcome measure in longitudinal studies. A French version of the SAS-SR is now available and is currently under evaluation in a large-scale randomized therapeutic trial.

Chronic Disease↗