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Perceptions and uses of Chinese medicine among the Chinese in Hong Kong.

The present paper was based on both qualitative observations and quantitative survey data. Major findings are as follows: (1) The sacred or magical-religious tradition of Chinese medicine is accepted by a relatively small portion (roughly one-fifth) of the ordinary Chinese people in urban Hong Kong, and is relatively more popular among women or less educated people. (2) Both the classical-professional and the local-empirical traditions of secular medicine are resorted to by many Chinese people (over one half) either for treating diseases or for strengthening their constitution. The acceptance of secular Chinese medicine does not vary significantly among different sex, age, education, or income groups. It should be noted that secular Chinese medicine is often used in addition to or in combination with modern Western medicine. (3) It appears that most people are more confident in the Chinese medical tradition than in Chinese-style practitioners in Hong Kong, and that people's confidence in secular Chinese medicine has been increasing in recent years. (4) There are reasons for the confidence in secular Chinese medicine. Chinese medicine is generally perceived to be better than or as good as Western, scientific medicine in some ways, such as for tonic care, for fewer side effects, for curing the cause (not symptoms) of diseases, and for treating certain diseases. Therefore, to ordinary Chinese people, Chinese and Western medicine may perform either equivalent or complementary functions. (5) As regards the process of seeking medical care, most people seem to follow the pattern of moving from self-medication, using Chinese and/or Western home remedies, to Western-style doctors, to Chinese-style practitioners, and finally to a Western medical hospital. Policy and theoretical implications of these findings are discussed.

Adolescent↗

Weight gain continues in the 1990s: 10-year trends in weight and overweight from the CARDIA study. Coronary Artery Risk Development in Young Adults.

The prevalence of obesity increased in the United States through the 1980s. The authors examined 10-year aging and secular (time-related) trends in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort for indications of whether these trends are continuing and for ages of peak weight gain in young adults. CARDIA is a population-based, prospective study of 5,115 African-American and White men and women aged 18-30 years at baseline. Body weight and overweight prevalence were measured at five time points from 1985-1986 to 1995-1996. Linear, mixed-model regression was used to partition weight gain into that due to secular trends and that due to aging. Prevalence of overweight (body mass index (BMI) > or = 25.0 kg/m2) increased markedly, and prevalence of severe obesity (BMI > or = 40.0 kg/m2) doubled in all race-sex groups. Each race-sex group experienced significant secular weight gains, ranging from 0.96 kg/year (95% confidence interval: 79, 1.13) in African-American women to 0.55 kg/year (95% confidence interval: 0.41, 0.69) in White women. Significant secular gains were present during each follow-up period. Each race-sex group also experienced significant weight increases related to aging during their early to midtwenties. Secular trends for weight gain are continuing in CARDIA, but the magnitude of weight gain differed among the four race-sex groups.

Adolescent↗

Nihilism, relativism, and Engelhardt.

This paper is a critical analysis of Tristram Engelhardt's attempts to avoid unrestricted nihilism and relativism. The focus of attention is his recent book, The Foundations of Bioethics (Oxford University Press, 1996). No substantive or "content-full" bioethics (e.g., that of Roman Catholicism or the Samurai) has an intersubjectively verifiable and universally binding foundation, Engelhardt thinks, for unaided secular reason cannot show that any particular substantive morality (or moral code) is correct. He thus seems to be committed to either nihilism or relativism. The first is the view that there is not even one true or valid moral code, and the second is the view that there is a plurality of true or valid moral codes. However, Engelhardt rejects both nihilism and relativism, at least in unrestricted form. Strictly speaking, he himself is a universalist, someone who believes that there is a single true moral code. Two argumentative strategies are employed by him to fend off unconstrained nihilism and relativism. The first argues that although all attempts to establish a content-full morality on the basis of secular reason fail, secular reason can still establish a content-less, purely procedural morality. Although not content-full and incapable of providing positive direction in life, much less a meaning of life, such a morality does limit the range of relativism and nihilism. The second argues that there is a single true, content-full morality. Grace and revelation, however, are needed to make it available to us; secular reason alone is not up to the task. This second line of argument is not pursued in The Foundations at any length, but it does crop up at times, and if it is sound, nihilism and relativism can be much more thoroughly routed than the first line of argument has it. Engelhardt's position and argumentative strategies are exposed at length and accorded a detailed critical examination. In the end, it is concluded that neither strategy will do, and that Engelhardt is probably committed to some form of relativism.

Bioethics↗

The commercialization of human body parts: a reappraisal from a Protestant perspective.

The idea of a market in human organs has traditionally met with widespread and emphatic rejection from both secular and religious fronts alike. However, as numerous human beings continue to suffer an uncertain fate on transplant waiting lists, voices are beginning to emerge that are willing at least to explore the option of human organ sales. Anyone who argues for such a option must contend, however, with what seem to be largely emotional rejections of the idea. Often it seems that rebuffs offered on a secular ground are rooted in nothing more than vague discomforts. We suspect that these discomforts are often based in religious sentiments that have wound their way into the fabric of secular America. Therefore, in order to contribute further to those voices heard in favor of human organ sales, it is worthwhile to show that from a religious perspective, it is just as possible to affirm the appropriateness of human organ sales as it is from a secular basis. Since Protestantism has historically had a powerful influence in American society it is a proper starting point for such an investigation.

Altruism↗

The foundations of bioethics: contingency and relevance.

In this essay, I proceed by, first, laying out H. Tristram Engelhardt's argument for the principle of permission as the proper foundation for a secular bioethic. After considering how a number of commentators have tried to undermine this argument, I show why it is immune to some of these advances. I then offer my own critique of Engelhardt's project. This critique is two pronged. First, I argue that Engelhardt is unable to establish his own foundation for a secular bioethic. This inability leaves him with only contingent points of departure for a secular bioethic, some of the more salient of which he has ignored. Second, I argue that even if Engelhardt's project succeeds, it is in danger of being irrelevant in a practical sense because it ignores important contextual dimensions of the peculiar enterprise we call bioethics. Ultimately, the proper foundations for a relevant secular bioethic. I argue, must appeal to certain contingent features of the context that gives rise to the need for it.

Bioethics↗

The new genetic technologies: why a theological perspective is necessary.

Secular bioethics poses questions that can be recognized as important, though it lacks the resources to answer them. Secular bioethics may retain the sense that there should be moral limits to the use of germline genetic engineering, but it lacks the basis to justify limits in principle. The contemporary practice of bioethics arose in the United States to fill a moral vacuum created by (1) the marginalization of medical ethics through the deprofessionalization of medicine, (2) the secularization of American society, and (3) an increased reliance on individual decision-making. The result is an ethics at the core of secular bioethics severed from a sense of ultimate purpose or direction for humans or the cosmos. This ethics and its bioethics are marked by (1) moral fragmentation and pluralism and (2) a loss of ultimate orientation. This bioethics can at best require (1) the prudent maximization of benefits over harms, (2) the condemnation of malevolent acts, and (3) the use of persons only with their consent. However, there fails to be a basis for a common view of benefit or of harm. Within this impoverished moral context, human biological nature can only appear to be a contingent outcome of spontaneous mutations, selective pressure, the constraints of physical laws, and random catastrophes. Such a bioethics, deprived of ultimate orientation, can provide no ground in principle for forbidding cloning, germline genetic engineering, or the fundamental recasting of human nature. Absent a theological point of orientation, medicine and the genetic technology are left with more power than ever but no clear moral sense of how to use that power.

Bioethics↗

Growth studies in Jena, Germany: Changes in thoracic measurements between 1975 and 1995.

This article presents the changes in three measurements of the thorax (chest depth, breadth, circumference) and in the chest index (chest depth / chest breadth) in 7-14-year-old school children from Jena between 1975 and 1995. Apart from the description of observed secular trends in body size (thorax measures) and form (index) of the thorax, age- and sex-specific differences are described. Boys have, on average, higher values of chest depth and chest breadth. Up to the age of 10, boys have a larger chest circumference at first, afterwards this is true for girls. The thoracic measurements increase under the influence of the secular trend. Since the individual measure- ments do not change in the same way, the trends suggest changes in proportions. Both sexes show similar secular trends, but the secular changes do not occur continuously, only intermittently. The results show that such intermittent changes occurred between 1985 and 1995. Am. J. Hum. Biol. 11:784-792, 1999. Copyright 1999 Wiley-Liss, Inc.

Journal Article↗

Factors affecting performance of prenatal genetic testing by Israeli Jewish women.

The number of prenatal genetic tests that are being offered to women is constantly increasing. However, there is little national data as to who is performing the tests and the reasons for doing or not doing so. This study evaluated the proportion of Jewish women in Israel who perform the various prenatal genetic tests and the factors affecting the performance of these tests. It was found that 60.9% of the women performed the triple test, 50.8% of women older than 35 years performed amniocentesis, while 63.3 and 24.3% of women performed Tay-Sachs and fragile-X carrier testing respectively. Ninety-six percent of the secular women compared to only 6.7% of the ultrareligious women performed the triple test. It was also found that94.4% of the secular women, 36.4% of the religious, and none of the ultrareligious women older than 35 years performed amniocentesis. In the stepwise regression analysis, being secular, having a higher income, fewer children, and being of Ashkenazi origin remained significant factors in determining performance of Tay-Sachs carrier testing. As regards fragile-X carrier testing, being secular, having fewer than four children, and having a higher income and a supplementary medical insurance remained significant factors. The main reason reported by the women for not performing amniocentesis or the triple test was for religious or moral grounds (53.3 and 67% respectively). The main reason given for not performing Tay-Sachs or fragile-X testing was that they were not referred for the tests (76 and 82% respectively). Consideration should be given to providing first trimester prenatal diagnosis to the ultrareligious group, including state subsidized fragile-X testing and educating the primary care givers about the importance of prenatal genetic testing. The information from the present study is vital for the planning of an equitable prenatal genetic service and provides guidelines for the implementation of such services in other countries.

Amniocentesis↗

Unusually low sexual dimorphism of endocranial capacity in a Zulu cranial series.

The mean cranial capacities of 50 male and 50 female Zulu crania were found to be 1373.3 +/- 107.4 ml for males and 1251.2 +/- 101.1 ml for females (means +/- SD). The male value resembles that of other Negro groups, while the female value is somewhat higher than the value for Negro crania as a whole. The index of sexual dimorphism is 8.9%, which is low when compared with those of other Negroid series and other populations. The possible causes for this form of a low sexual dimorphism are as follows: A negative secular trend, with the assumption that the Zulu crania were larger than those of the reference populations of African Negroids before the start of the secular trend change. This would seem to be the most likely possibility, with some supporting evidence for both parts of the explanation. An absence of secular trend, with a demographic sampling aberration, in which large females and small males of the population are sampled. This possibility cannot be totally excluded. An absence of secular trend, with a genetic difference in sexual dimorphism for cranial capacity between the Zulu and the reference populations. While this possibility cannot be excluded, it would be the least preferable explanation.

Adult↗

Gender identity, nationalism, and social action among Jewish and Arab women in Israel: redefining the social order?

In the study this article explores, the meaning of gender identity for religious and secular Jewish and Arab women in Israeli society is examined. The study focuses on how Israeli women, rank gender identity, relative to other identities like being Jewish/Arab, being Israeli/Palestinian, religious or secular, of a certain ethnic group, and political identity. It examines the characteristics of gender identity and the attitudes that are associated with it. The analysis shows that the hierarchies of identities are different for religious and secular Jewish and Arab women, and that this is related to having different sociopolitical attitudes (e.g., Women's social and political involvement, social obedience, social influence). Thus, the hierarchy of identities and the sociopolitical attitudes of religious women indicate a more consensual acceptance of the social order than the hierarchy of identities and the sociopolitical attitudes of secular women, especially among Arab women.

Asia↗

The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900.

BACKGROUND: We examined the relationship of the number of adverse childhood experiences (ACE score) to six health problems among four successive birth cohorts dating back to 1900 to assess the strength and consistency of these relationships in face of secular influences the 20th century brought in changing health behaviors and conditions. We hypothesized that the ACE score/health problem relationship would be relatively "immune" to secular influences, in support of recent studies documenting the negative neurobiologic effects of childhood stressors on the developing brain. METHODS: A retrospective cohort study of 17,337 adult health maintenance organization (HMO) members who completed a survey about childhood abuse and household dysfunction, as well as their health. We used logistic regression to examine the relationships between ACE score and six health problems (depressed affect, suicide attempts, multiple sexual partners, sexually transmitted diseases, smoking, and alcoholism) across four successive birth cohorts: 1900-1931, 1932-1946, 1947-1961, and 1962-1978. RESULTS: The ACE score increased the risk for each health problem in a consistent, strong, and graded manner across four birth cohorts (P < 0.05). For each unit increase in the ACE score (range: 0-8), the adjusted odds ratios (ORs) for depressed affect, STDs, and multiple sexual partners were increased within a narrow range (ORs: 1.2-1.3 per unit increase) for each of the birth cohorts; the increase in risk for suicide attempts was stronger but also in a narrow range (ORs: 1.5-1.7). CONCLUSIONS: Growing up with ACEs increased the risk of numerous health behaviors and outcomes for 20th century birth cohorts, suggesting that the effects of ACEs on the risk of various health problems are unaffected by social or secular changes. Research showing detrimental and lasting neurobiologic effects of child abuse on the developing brain provides a plausible explanation for the consistency and dose-response relationships found for each health problem across birth cohorts, despite changing secular influences.

Adult↗

Study of relaxation rates of stable paramagnetic centers in gamma-irradiated alanine.

The stable L-alanine radical induced by gamma-irradiation was examined by electron paramagnetic resonance (EPR), transfer saturation EPR and electron nuclear double resonance (ENDOR) in the temperature region of fast motion of the methyl group (180-320 K). From the obtained spectral line broadening and spectral intensity the correlation time for the methyl rotation was estimated. The complex processes determining the relaxation rate were examined in the same temperature interval. It was shown that important contributions to the relaxation rate arise from non-secular and pseudo-secular types of contributions. The non-secular contribution involves intramolecular dynamics while the pseudo-secular contribution originates from intermolecular motions. The obtained values for the dynamical parameters have been compared with those obtained by pulse EPR methods and by proton nuclear magnetic resonance (NMR) on undamaged crystals.

Alanine↗

The origin of geomagnetic jerks.

Geomagnetic jerks, which in the second half of the twentieth century occurred in 1969 (refs 1, 2), 1978 (refs 3, 4), 1991 (ref. 5) and 1999 (ref. 6), are abrupt changes in the second time-derivative (secular acceleration) of the Earth's magnetic field. Jerks separate periods of almost steady secular acceleration, so that the first time-derivative (secular variation) appears as a series of straight-line segments separated by geomagnetic jerks. The fact that they represent a reorganization of the secular variation implies that they are of internal origin (as has been established through spherical harmonic analysis), and their short timescale implies that they are due to a change in the fluid flow at the surface of the Earth's core (as has also been established through mapping the time-varying flow at the core surface). However, little is understood of their physical origin. Here we show that geomagnetic jerks can be explained by the combination of a steady flow and a simple time-varying, axisymmetric, equatorially symmetric, toroidal zonal flow. Such a flow is consistent with torsional oscillations in the Earth's core, which are simple oscillatory flows in the core that are expected on theoretical grounds, and observed in both core flow models and numerical dynamo models.

Journal Article↗

Trends in overweight and obesity from 1985 to 2002 in Göteborg, West Sweden.

OBJECTIVE: To study secular trends in overweight and selected correlates in men and women in Göteborg, Sweden. DESIGN: Cross-sequential population-based surveys. SUBJECTS: A total of 2931 female and 2691 male subjects aged 25-64 y participated in WHO MONICA surveys (1985, 1990, 1995) and the INTERGENE study (2002). MEASUREMENTS: Body mass index (BMI), waist-to-hip ratio (WHR), prevalence of overweight (BMI> or =25 kg/m(2)), and obesity (BMI> or =30 kg/m(2)). RESULTS: Mean body weight increased by 3.3 kg for women and 5 kg for men, with a significant upward trend for BMI in men but not women over the 17-y observation period. The prevalence of overweight and obesity increased significantly in both sexes over the period. The largest increase was observed in men, and in women aged 25-34 y. In 2002, the prevalence of overweight was 38% in women and 58% in men, and the prevalence of obesity was 11% in women and 15% in men. No significant secular trends were observed for WHR, but there was an upward trend in prevalence of WHR>0.85 in women. A decreased prevalence of smoking in both sexes was observed together with an increase in reported leisure time physical activity. No significant secular trends were observed in rates of self-reported diabetes, although the risk of diabetes attributable to obesity was 24%. CONCLUSION: The results indicate that 25-64-y-olds in the recent survey were more overweight and obese than earlier studied MONICA participants. The increase in BMI was more pronounced in men while abdominal obesity increased principally in women. Although obesity and overweight are clearly important risk factors for type 2 diabetes, the number of diabetics remains low and any secular increase is not yet apparent.

Adult↗

The 'oestrogen hypothesis'- where do we stand now?

The original 'oestrogen hypothesis' postulated that the apparent increase in human male reproductive developmental disorders (testis cancer, cryptorchidism, hypospadias, low sperm counts) might have occurred because of increased oestrogen exposure of the human foetus/neonate; five potential routes of exposure were considered. This review revisits this hypothesis in the light of the data to have emerged since 1993. It addresses whether there is a secular increasing trend in the listed disorders and highlights the limitations of available data and how these are being addressed. It considers whether new data has emerged to support the suggestion that increased oestrogen exposure could cause these abnormalities and reviews new data on potential routes via which such increased exposure could have occurred. Secular trends: The disorders listed above are now considered to represent a syndrome of disorders (testicular dysgenesis syndrome, TDS) with a common origin in foetal life. Testicular cancer has increased in incidence in Caucasian men worldwide and lifetime risk is 0.3-0.8%. Secular trends in cryptorchidism are unclear but it is by far the commonest (2-4% at birth) congenital abnormality in either sex. Secular trends for hypospadias are not robust, although most studies suggest a progressive increase; registry data probably under-estimates incidence, but based on this data hypospadias is the second most common (0.3-0.7% at birth) congenital malformation. Retrospective analyses of sperm count data show a global downward trend but this is inconclusive - prospective studies using standardized methodology show significant differences between countries and very low sperm counts in the youngest cohort of men. For all disorders, other then testis cancer, standardized prospective studies are the best way forward and are in progress across Europe. Oestrogen effects: Evidence that foetal exposure to oestrogens can induce the above disorders has strengthened. New pathways via which such changes could be induced have been identified, including suppression of testosterone production by the foetal testis, suppression of androgen receptor expression and suppression of insulin-like factor-3 (InsL3) production by foetal Leydig cells. Other evidence suggests that the balance between androgen and oestrogen action may be important in induction of reproductive tract abnormalities. Oestrogen exposure: Although many new environmental oestrogens have been identified, their uniformly weak oestrogenicity excludes the possibility that they could induce the above disorders. However, emerging data implicates various environmental chemicals in being able to alter endogenous levels of androgens (certain phthalates) and oestrogens (polychlorinated biphenyls, polyhalogenated hydrocarbons), and the former have been shown to induce a similar collection of disorders to TDS. Other mechanisms via which increased fetal exposure to pregnancy oestrogens might occur (increasing trend in obesity, dietary changes) are also discussed.

Estrogens↗

Is analytical psychology a religion? Rationalist and romantic approaches to religion and modernity.

The relationship between analytical psychology and religion is part of the larger issue of the relationship between modernity and religion. There are three main views on the issue. The fundamentalist position sets religion against modernity and opts for religion over modernity. What I call the 'rationalist' position likewise sets religion against modernity but opts for modernity over religion. By contrast to both views, what I call the 'romantic' position reconciles religion with modernity. Rationalists maintain that religion can exist only in so far as it serves as an explanation of the physical world, which the rise of science now precludes. Romantics maintain that religion, while serving as an explanation of the physical world till dislodge by science, is at heart anything but an explanation. The toppling of the religions explanation by the scientific one, far from dooming religion, prods religion into making explicit what it has in fact been all along. By this categorization, Jung is overwhelmingly a romantic. For him, the function of religion has always been more psychological than explanatory, and the rise of science does not preclude the continuing existence of religious myths as a psychological rather than an explanatory phenomenon. For those for whom science does spell the demise of religion, secular myths can replace religious ones, and those secular myths are more secular versions of religions myths than secular alternatives to religions myths. Yet even if for Jung religion can still exist today because religion is in fact psychology, it does not follow that psychology is therefore a religion.

Christianity↗

A kaleidoscope of understandings: Spiritual nursing in a multi-faith society.

BACKGROUND: Spirituality is an increasingly discussed topic in nursing. In some parts of the UK there is a policy requirement to establish policies of spiritual health care which are appropriate to a multi-cultural society. In the nursing literature, spirituality is discussed from religious and secular perspectives which seem impossible to reconcile into a coherent philosophy. AIMS: To discuss the relationship of spirituality to nursing and to suggest how we can think about spirituality as nurses working in a society of many faiths and cultures. DISCUSSION: Spirituality can be thought of in relation to individual patients and nurses. It also has significance for the profession of nursing and for health care as a whole. The difficulty of defining spirituality is discussed, and it is suggested that a definition of 'spiritual nursing' may be more achievable. Different concepts of spirituality are compared, including religious and secular spirituality. The relationship between religion and spirituality is seen as potentially problematic, with some religions denying the existence of secular spirituality. Secular spirituality and New Age movements are non-religious but spiritually influential phenomena. The problem for nursing is how to reconcile the immense variety of approaches to spirituality. CONCLUSIONS: The concept of spirituality as a meta-narrative is considered, and a postmodern appreciation of pluralism is employed as a way of embracing different spiritual realities. Spiritual nursing can be an opportunity for nurses to enlarge their understanding of the human condition rather than a narrowly defined concept to be applied within a model of practice.

Cultural Diversity↗

Pupil size in Jewish theological seminary students.

PURPOSE: To investigate the authors' clinical impression that pupil size among myopic Jewish theological seminary students is different from pupil size of similar secular subjects. METHODS: This cross-sectional study was conducted on 28 male Jewish theological seminary students and 28 secular students or workers who were matched for age and refraction. All participants were consecutively enrolled. Scotopic and photopic pupil size was measured by means of a Colvard pupillometer. Comparisons of various parameters between the groups were performed using the two-sample t-test, Fisher exact test, a paired-sample t-test, a two-way analysis of variance, and Pearson correlation coefficients as appropriate. RESULTS: The two groups were statistically matched for age, refraction, and visual acuity. The seminary students were undercorrected by an average of 2.35 diopters (D), while the secular subjects were undercorrected by only 0.65 D (p<0.01). The average pupil size was larger in the religious group under both scotopic and photopic luminance. This difference was maintained when the two groups were compared according to iris color under both conditions, reaching a level of statistical significance (p<0.0001). There was a significant difference in photopic pupil size between dark and light irises (p=0.049), but this difference was not maintained under scotopic conditions. CONCLUSIONS: The average pupil size of young ultraorthodox seminary students was significantly larger than that of matched secular subjects. Whether this is the result of intensive close-up work or of apparently characteristic undercorrection of the myopia is undetermined.

Adult↗