Health-related quality of life among Jewish older persons in Mexico and its determinants.

PURPOSE: Aging research in Mexico has significantly increased in the past decades, however, little is known on health related quality of life (HRQoL) of older adults. The aim of this study was to expand this field by examining HRQL in a representative sample of Jewish older adults in Mexico, and to investigate its association with different factors. METHODS: This was a cross-sectional survey of a random sample of community dwelling Jewish men and women aged 60 years and older. HRQoL was measured using the Short Form Health Survey (SF-36). Bivariate analysis was performed to estimate the association of scores of HRQoL and different characteristics of the study sample and multiple linear regression models were estimated using ordinary least squares (OLS), to explore determinant factors associated to HRQoL in this sample, for the eight domains of the SF-36 sub-scales separately. RESULTS: Two hundred ninety-five older persons were interviewed. Mean age was 72.7 years (SD 7.9), men made up 57% of the sample, 67% were married and 52% reported living with another person, mostly the spouse. Higher HRQoL was associated with higher educational attainment, being married, and having higher social support, while lower HRQoL was associated with being widowed, in worse financial situation, having chronic diseases and being in the oldest age groups. CONCLUSIONS: Findings show that gender, socioeconomic level, educational attainment, marital status as well as social support & community participation are relevant factors influencing HRQoL in our study sample. With respect to the SF-36 subscales, HRQoL of Jewish older adults in Mexico present higher scores than that of adults and older adults previously found in other studies in Mexico. Further studies comparing other characteristics among them could help bring further understanding of these differentiated ageing processes.

The dialectics of universality: The heterodox critical social theory of Robert Fine.

Robert Fine was among the most original social theorists in Britain of the past 30 years, and the aim of this paper is to offer a first systematic assessment of his intellectual contribution. There are sound intellectual reasons to explore Fine's scholarship. He maintained a problematic relation with mainstream sociology and, against the reduction of sociology to questions of method, culture, or class, he argued that sociologists must continue to ask difficult normative questions as part of the social world they ought to explain. And there are also pressing political concerns that justify a reconsideration of his writings. Global politics is currently marked by a populist wave that decries the very ideas and values that were central to Fine's social theory: the need to uphold the rule of law at home and abroad, the politics of cosmopolitan solidarity, and the significance of antisemitism and its relationships with different forms of authoritarian politics. My main argument is that there is a dialectics of universality that drives forward Fine's intellectual project. By this, I mean that a universalistic idea of humanity-an all-inclusive conception of all human beings-is the most important normative intuition of modern times. This idea of humanity moves forward in history through a dual process of emancipation and domination: successful forms of social, legal, and political inclusion help make visible previous dynamics of exclusion but may also create or recreate discriminatory practices. Building on the work of French historian Michael Löwy on heterodox Jewish thinkers, I explain the three main tenets of Fine's work: (a) his reconstruction of critical social theory; (b) the notion of cosmopolitan solidarity; and (c) the significance and main features of modern antisemitism.

Depression and cancer were independently associated with quality of life in Brazilian older people.

OBJECTIVE: To analyse the factors associated with low health-related quality of life (HRQoL) in older people living in Brazil. METHODS: In this cross-sectional study of the Jewish community residing in Sao Paulo, Brazil, we extensively evaluated the characteristics - including clinical, functional and sociodemographic - of 496 older people. Quality of life was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF), while the Geriatric Depression Scale (GDS) was used to measure depressive symptoms. RESULTS: After adjusting for potential confounders, we found that GDS score (ß = -0.07; P = 0.04) and cancer (ß = -0.47; P = 0.05) were associated with a low WHOQOL-BREF score. CONCLUSION: Depressive symptoms and cancer were independently associated with low HRQoL among older people living in Brazil.

Cultural aspects of healthy BRCA carriers from two ethnocultural groups.

We explored the experiences of Ashkenazi Jewish and French Canadian women and meanings attributed to their hereditary breast and ovarian cancer (HBOC) risk. We purposively sampled 40 BRCA1 or BRCA2 (BRCA) mutation carriers and conducted theoretically driven semistructured interviews. According to content analysis, participants from these two ethnocultural groups held divergent meanings associated with being a BRCA carrier and different views pertaining to the illness experience and risk awareness. All participants identified a genetic basis; however, the French Canadian women also expressed other causes. The French Canadian women reported not knowing other carriers in their social environment, whereas the Ashkenazi Jewish women emphasized a strong sense of community contributing to their ethnic risk awareness. Based on these findings, we suggest that French Canadian women could benefit from greater awareness of the HBOC genetic risk and that health care providers should consider ethnically related and individual-based experiences and meanings during counseling.

The doctor-patient relationship and how it might apply to world affairs: a saga of warts.

A prospective patient in an experimental trial on immunotherapy for warts that I was performing was Palestinian. I advised him that I was Jewish, because I feared his reaction in the domain of an experimental therapeutic trial. The patient rhetorically asked whether I was a physician. If so, no problems should exist. He was admitted to the trial and healed. Reason and common interest may vanquish fear and mistrust. Can this teaching be applied to the Middle East situation? Hatred would have to be defeated first.

Symptomatic expression of depression among Jewish adolescents: effects of gender and age.

BACKGROUND: Depression symptomatology was assessed with the Beck Depression Inventory (BDI) in a sample of Jewish adolescents, in order to compare the frequency and severity of depression with non-Jewish adolescents as well as examine gender difference of the expression of depressive symptomatology. METHOD: Subjects comprised 475 students from Jewish private schools, aged 13-17 years, who were compared with an age-matched non-Jewish sample (n=899). Kendall's definition was adopted to classify these adolescents according to level of depressive symptoms. The frequency of depression was calculated for ethnicity, gender and age strata. Discriminant analysis and principal component analysis were performed to assess the importance of depression-specific and non-specific items, along with the factor structure of the BDI, respectively. RESULTS: The overall mean score on the BDI in the Jewish and the non-Jewish sample was 9.0 (SD=6.4) and 8.6 (SD=7.2), respectively. Jewish girls and boys had comparable mean BDI scores, contrasting with non-Jewish sample, where girls complained more of depressive symptoms than boys (p<0.001). The frequency of depression, adopting a BDI cutoff of 20, was 5.1% for the Jewish sample and 6.3% for the non-Jewish sample. The frequency of depression for Jewish girls and boys was 5.5% (SE=1.4) and 4.6% (SE=1.5), respectively. On the other hand, the frequency of depression for non-Jewish girls and boys was 8.4% (SE=1.2) and 4.0% (SE=1.0), respectively. The female/male ratio of frequency of BDI-depression was 1.2 in the Jewish sample, but non-Jewish girls were twice (2.1) as likely to report depression as boys. Discriminant analysis showed that the BDI highly discriminates depressive symptomatology among Jewish adolescents, and measured specific aspects of depression. Factor analysis revealed two meaningful factors for the total sample and each gender (cognitive-affective dimension and somatic dimension), evidencing a difference between Jewish boys and Jewish girls in the symptomatic expression of depression akin to non-Jewish counterparts. CONCLUSIONS: Ethnic-cultural factor might play a role in the frequency, severity and symptomatic expression of depressive symptoms in Jewish adolescents. The lack of gender effect on depression, which might persist from adolescence to adulthood among Jewish people, should be investigated in prospective studies.

Identidade judaica: formação, manutenção e possível modificação à luz da Psicologia Social / Jewish identity: formation, maintenance and possible modification under Social Psychology

A pesquisa examinou a configuração de ser judeu, a partir da Psicologia Social. Tal proposta reuniu considerações teóricas e observações empíricas. Quanto àquelas, foram elaborados comentários sobre identidades psicossociais, judaísmo, entre outras questões. Quanto aos aspectos empíricos, foi desenvolvido estudo de campo, com aplicação de questionário com perguntas abertas, cujas respostas foram examinadas com base na análise de conteúdo. Participaram da pesquisa 80 israelitas, sendo 40 ashkenazim e 40 sefaradim, cujas idades variaram entre 15 e 81 anos. Estes grupos foram compostos, respectivamente, por 20 homens e mulheres, dos quais 10 apresentavam nível médio e 10 superior de escolaridade. Resultados indicaram presença comum de categorias entre ashkenazim e sefaradim. Conclui-se que ser judeu compreendia, sobretudo, aspectos religiosos e culturais. Quanto aos processos de formação, manutenção e modificação, houve predominância de fatores culturais e educacionais; culturais, religiosos, emocionais e sociais; e socioculturais(AU)

[Return to Germany--personal motive and markers of the subjective life space of Jewish emigrants]. / Rückkehr nach Deutschland--persönliche Motive und Merkmale des subjektiven Lebensraums jüdischer Emigranten.

120 Jewish people who were forced to emigrate from Germany to Israel or Argentinia during the "Third Reich" were interviewed. Interviews dealt with the psychic situation; additionally, scales were applied for measurement of morale, attitudes towards the present situation and the future, and perceived changeability of the situation. The group of emigrants was divided into two subgroups: Emigrants who stayed in foreign countries, and emigrants who returned to Germany in old age. The emigrants were compared with a control-group of german people who were not discriminated against and persecuted, and who were not forced to emigrate. Significant differences between the two groups were found: The emigrants showed a higher degree of perceived changeability and a more positive life-review. Perceived stress and activity in different intra- and extrafamilial roles were higher. Emigrants who had gone back to Germany showed a higher degree of perceived changeability and a lower degree of sorrow concerning personal future than emigrants who stayed in Israel or Argentinia. Perceived stress in extrafamilial roles was higher. Additionally, motives for going back to Germany and for staying in Israel or Argentinia were analyzed.

A cross-cultural family history study of primary progressive dementia in relatives of nondemented elderly Chinese, Italians, Jews and Puerto Ricans.

Very few studies have directly compared the risk for Alzheimer's disease in different ethnic groups. This may be due in part to the costs and methodological difficulties associated with conducting traditional epidemiological studies. The family history method, in which information is collected on the dementia status of relatives of normal elderly members of ethnic groups of interest, offers a less costly and more practical preliminary approach. In the present study, 6866 first-degree relatives of 924 elderly, nondemented index subjects (305 Chinese, 212 Jewish, 215 Italian and 192 Puerto Rican, living in New York City) were assessed through family history interview for progressive primary and other dementias using previously published family history criteria. Both the Jewish and Italian groups had significantly increased cumulative risk for progressive primary dementia compared with both the Chinese and Puerto Rican groups. Although possible methodological biases cannot be discounted, these results appear to reflect differences between ethnic groups in the degree of risk for dementia.

High levels of sensitivity to alcohol in young adult Jewish men: a pilot study.

This article compares the intensity of response to ethanol in 15 men who reported having Jewish mothers and fathers with the responses of 15 non-Jews who have a close alcoholic relative (FHP) and 15 non-Jews who have no such family history (FHN). After matching the three groups on demography and drinking history, there were no differences on their expectations of the effects of alcohol, nor on the blood alcohol concentrations following the consumption of 0.75 ml/kg of ethanol. However, the men who considered themselves as having a Jewish heritage evidenced significantly more intense subjective feelings after the alcohol challenge, with a similar but nonsignificant trend observed for their level of postdrinking body sway.

The imitation of madness: the influence of psychopathology upon culture.

Psychiatry and ethnography have been reluctant to consider the possibility that psychosis may provide a model for social organisation and belief. The situations in which this may occur are considered and two examples discussed: the historical leader of a Jewish messianic movement and the contemporary founder of a Trinidadian sect. Individual delusions may be converted into a shared public culture by the manipulation of previously accepted symbolism and a simple inversion of the traditional values in some area may enable the whole community to attain a more sophisticated conceptualisation. In particular, antinomian acts rooted in psychopathology may generate more universal dispensations out of systems of dual classification.

Ethnicity and the pain experience.

The first objective of this investigation was to examine interethnic differences and similarities in the reported pain experience of Black, Irish, Italian, Jewish and Puerto Rican facial pain patients. Responses, attitudes and descriptions were found to be relatively similar after controlling for most variables shown by previous studies to influence reported pain experience. These variables include symptom history, signs elicited on physical, radiographic and laboratory examination, as well as social, cultural and psychological data. A thirty-five item scale was employed to measure patients' pain experience. Using analysis of variance and covariance, no significant interethnic differences were found for twenty-three (65.7%) of the items. The majority of the twelve items for which interethnic differences were found concerned the patients' emotionality (stoicism vs expressiveness) in response to pain, and interference in daily functioning attributed to pain. The pain experiences reported by the Black, Italian and Jewish patients were found most similar as measured by the twelve items. Irish and Puerto Rican patients appeared relatively distinct from the other groups as well as from each other. The second objective of this study was to identify particular variables that influence intraethnic variation in the pain experience. These were determined by multiple regression analysis of two summary indices previously derived by factor analysis of the thirty-five items. The specific variables which were most influential differed according to ethnicity, as follows: degree of medical acculturation for Black patients; degree of social assimilation for Irish patients; duration of pain for Italian patients; and level of psychological distress for Jewish and Puerto Rican patients. Thus, it appears that, in our study population, interethnic homogeneity is present for most aspects of the pain experience, while intraethnic heterogeneity exists for factors that may influence that experience. That is, the five ethnic groups were generally found to be similar in their reported responses to pain. Yet, each group was quite different with regard to factors which influence the responses.

Infantile autism and childhood schizophrenia: review of the issues from the sociocultural point of view.

After presenting an historical overview of the development of the concept of childhood psychosis, this paper discusses the various etiologies which have been offered to explain severe disturbances of childhood. Reference is made to the nature/nurture polemic. In spite of the general belief that the etiology is biologically determined, particularly in infantile autism, the actual evidence tends to be meagre. Furthermore, the literature includes a number of studies which have been found to be methodically weak and which seem to disclaim the intellectual and socioeconomic superiority of the parents of autistic children, contrary to Kanner's original finding that such superiority exists. The link between social class and autism, according to Cantwell's review, does not appear to fit a purely biological causation of autism. This remains an awkward finding which still demands an explanation. The contention of this paper is that contradictory findings could be explained, as stated by Kanner, by the 'inordinate' use of the label 'autism' to include various types of children's severe disorders, even brain-damaged children. Furthermore this review emphasizes the fact that a total neglect of sociocultural variables in the study of such children has led to confounding results. A careful reading of the literature and correspondence with numerous psychiatrists around the world have led the author to believe that infantile autism is more prevalent in highly technological countries where there is extensive geographical and economic mobility coupled with the nuclearization of the family. This paper offers supportive evidence for this speculation.