With new treatments targeting features of schizophrenia associated with functional disability, there is a need to evaluate the validity of ratings of everyday outcomes. It is unknown whether patients can validly self-report on aspects of their functional status, which would be a potentially economical method for obtaining outcome data. In this study, 67 older schizophrenia outpatients provided self-ratings of everyday real-world functioning using the specific levels of functioning scale (SLOF). They were also administered assessments of neuropsychological performance, performance-based measures of functional capacity and social skills, clinical symptoms, and quality of life. Case managers, unaware of other ratings, also generated SLOF ratings. Based on discrepancy scores, participants were categorized as accurate raters (n = 24), underestimators (n = 16), or overestimators (n = 27) of their functional status as compared to case managers' ratings. Patients' self-rated functional status was correlated with their subjective quality of life, but remarkably unassociated with case manager ratings of functional status or their own performance on functional capacity or social skills measures. Case manager ratings, however, were highly correlated with performance on functional capacity and social skills measures. Patients who underestimated their real world performance had better cognitive skills and greater self-rated depression than those who overestimated. Accurate raters demonstrated greater social skills than both overestimators and underestimators, while overestimators were most cognitively and functionally impaired. Accurate ratings of everyday outcomes in schizophrenia may require systematic observation of real world outcomes or performance-based measures, as self-reports were inconsistent with objective information.
Dalam sistem sastera Melayu tradisi, tidak terdapat istilah yang khusus mengenai makna kepengarangan kerana ia membawa maksud yang berbeza dengan sistem kepengarangan sastera Melayu moden. Dalam sistem sastera Melayu tradisi, makna kepengarangan itu boleh dibezakan dengan peranan pencerita. Berdasarkan kesedaran diri sastera Melayu tradisi, seseorang pengarang itu berfungsi berdasarkan peranan penceritaannya yang mana setiap karya yang dihasilkan mestilah berlandaskan kepada kesedaran mereka tentang sistem sastera Melayu tradisi. Pengarang sastera tradisi boleh sahaja memilih untuk melahirkan karya yang bersifat "soothing text" iaitu karya yang boleh melekakan, melalaikan, menghiburkan ataupun karya yang bersifat "benefecial text" iaitu karya yang dapat mendidik akal, minda dan jiwa pembaca serta tidak bersifat melalaikan atau penuh nilai-nilai hiburan semata-mata. Makalah ini akan membincangkan peranan pencerita dagang di bahagian kepengarangan Melayu tradisi berdasarkan model Koster mengenai Idea Buku (Braginsky, 1998). Menyingkap teks sastera sejarah, terakam di dalamnya perihal dunia politik yang amat rencam. Penuh di dalamnya rakaman peristiwa yang boleh menjadi panduan dan pedoman untuk masyarakat kini.Walaupun zaman telah berubah, tetapi lipatan sejarah harus dibuka, diingati, dihayati dan dipelajari supaya manusia pada hari ini boleh mengulang zaman kegemilangan Melayu dahulu melalui formula yang telah tersedia ada dalam teks-teks sastera sejarah. Ia juga wajar dihayati supaya manusia kini tidak mengulang kembali kesilapan yang boleh menghancurkan bangsa sendiri. Masyarakat kini yang tidak memahami sastera sejarah sering mempunyai salah tafsiran terhadap teks ini. Mereka bersikap objektif dalam meletakkan hasil teks sastera sejarah seperti mana yang telah dilakukan oleh pengakaji-pengkaji barat yang terdahulu. Sastera sejarah terdiri daripada bentuk cerita, prosa dan puisi. Di antara beberapa contoh teks sastera sejarah ialah Sejarah Melayu (1996), Tuhfat Al Nafis (1982).
Female genital mutilation/cutting (FGM/C), officially referred to as female circumcision and at community level as tahara (cleanliness), is still prevalent in Egypt. This study was designed to examine the role of female sexuality in women's and men's continued support for FGM/C, and their perceptions of its sexual consequences. The study was conducted in 2008–09 in two rural communities in Upper Egypt and a large slum area in Cairo. Qualitative data were collected from 102 women and 99 men through focus group discussions and interviews. The clitoris was perceived to be important to, and a source of, sexual desire rather than sexual pleasure. FGM/C was intended to reduce women's sexual appetite and increase women's chastity, but was generally not believed to reduce women's sexual pleasure. Men and women framed sexual pleasure differently, however. While men, especially younger men, considered sexual satisfaction as a cornerstone of marital happiness, women considered themselves sexually satisfied if there was marital harmony and their socio-economic situation was satisfactory. However, sexual problems, including lack of pleasure in sex and sexual dissatisfaction, for whatever reasons, were widespread. We conclude that political commitment is necessary to combat FGM/C and that legal measures must be combined with comprehensive sexuality education, including on misconceptions about FGM/C.La mutilation sexuelle féminine/excision (MSF), appelée aussi circoncision féminine et tahara (purification) au niveau communautaire, est encore très répandue en Égypte. Cette étude avait pour but d'examiner le rôle de la sexualité féminine dans le soutien qu'hommes et femmes continuent d'apporter à cette pratique, et leurs perceptions de ses conséquences sexuelles. L'étude a été réalisée en 2008–09 dans deux communautés rurales de Haute-Égypte et un vaste bidonville du Caire. Des données qualitatives ont été recueillies auprès de 102 femmes et 99 hommes par des entretiens et des discussions en groupes d'intérêt. Le clitoris était jugé important et source de désir sexuel plutôt que de plaisir sexuel. La MSF servait à réduire l'appétit sexuel des femmes et favoriser leur chasteté, mais en général, on ne pensait pas qu'elle réduisait le plaisir sexuel féminin. Néanmoins, les hommes et les femmes concevaient différemment le plaisir sexuel. Alors que les hommes, en particulier les plus jeunes, considéraient la satisfaction sexuelle comme la clé de voûte du bonheur conjugal, les femmes s'estimaient sexuellement satisfaites si l'harmonie régnait dans leur ménage et si leur situation socio-économique était bonne. Les problèmes sexuels, notamment le manque de plaisir pendant les rapports et l'insatisfaction sexuelle, toutes raisons confondues, étaient cependant fréquents. Nous en concluons qu'un engagement politique est nécessaire pour lutter contre la MSF et qu'il faut associer des mesures juridiques à une éducation sexuelle complète, y compris sur les idées fausses relatives à la MSF.La ablación o mutilación genital femenina (MGF), oficialmente conocida como circuncisión femenina y a nivel comunitario como tahara (aseo), aún es frecuente en Egipto. Este estudio fue diseñado para examinar el papel de la sexualidad femenina en el continuo apoyo de la MGF por hombres y mujeres, y sus percepciones de sus consecuencias sexuales. El estudio fue realizado en 2008–09 en dos comunidades rurales en Alto Egipto y en una amplia zona de barrios bajos del Cairo. Se recolectaron datos cualitativos de 102 mujeres y 99 hombres, por medio de discusiones en grupos focales y entrevistas. El clítoris era percibido como algo importante para el deseo sexual y como una fuente de deseo sexual en vez de placer sexual. La MGF tenía como objetivo reducir el apetito sexual de las mujeres y aumentar su castidad, pero generalmente no se consideraba como algo para disminuir el placer sexual de las mujeres. No obstante, la definición de placer sexual ofrecida por los hombres era distinta a la de las mujeres. Mientras que los hombres, especialmente los más jóvenes, consideraban la satisfacción sexual como algo fundamental para la felicidad matrimonial, las mujeres se consideraban sexualmente satisfechas si había armonía conyugal y su situación socioeconómica era satisfactoria. Sin embargo, los problemas sexuales como la falta de placer sexual y la insatisfacción sexual, por las razones que fueran, eran extendidos. Concluimos que el compromiso político es necesario para combatir la MGF y que las medidas jurídicas se deben combinar con una educación sexual integral, que aborde las ideas erróneas respecto a la MGF.
During August 17th–21st, 2014, the University of Alaska Anchorage, along with other local, state, and federal agencies throughout Alaska, will host the 20th International Epidemiological Association's (IEA) World Congress of Epidemiology (WCE 2014). The theme for this Congress is "Global Epidemiology in a Changing Environment: The Circumpolar Perspective." The changing environment includes the full range of environments that shape population health and health inequities from the physical to the social and economic. Our circumpolar perspective on these environments includes views on how political systems, work, immigration, Indigenous status, and gender relations and sexuality affect the global world and the health of its people. Suggestions and insights from the 3rd North American Congress of Epidemiology (2011) and the first-ever joint regional workshop co-organized by the IEA North American Region and the IEA Latin American and Caribbean Region held at the 19th IEA World Congress of Epidemiology (2011) have helped direct the focus for WCE 2014. Since the Arctic regions are feeling the effects of climate change first, we believe focusing on the emerging data on the health impacts of climate change throughout the world will be an important topic for this Congress. This will include a broad range of more traditional epidemiology areas such as infectious disease epidemiology, environmental epidemiology, health disparities, and surveillance and emergency preparedness. Addressing health inequities and promoting health equity is likewise a key concern of the Congress. This Congress will also host presentations on injury epidemiology, occupational health, infectious diseases, chronic diseases, maternal and child health, surveillance and field epidemiology, mental health, violence (from self-directed, e.g., suicide, to interpersonal to structural), psychoactive substance use (including tobacco), and measures of subjective health. Attention will be given to epidemiology's theoretical frameworks and emphasizing knowledge translation, from epidemiology to health systems, to policy, and to the broader public. We also plan to offer many hands-on workshops including practical uses of epidemiology to improve health systems and reduce health inequities within and between countries; the manner in which epidemiology can inform public health practice; the understanding and use of the Dictionary of Epidemiology; and many others.
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