Understanding injury-related disability in non-Western societies can contribute to more effective road safety policies and programs

• Road crashes as a cause of disability • Disability in the study of road safety • Thai spinal injury study – Contextual information – beliefs and community – Transport system and hidden safety costs – Cambodia experience – Pakistan fatalism study • Feedback to policies and programs

Under-reporting of road crashes in Pakistan and the role of fate

Objective: Comprehensive, accurate information about road crashes and related trauma is a prerequisite for identification and control of risk factors as well as for identifying faults within the broader road safety system. Quality data and appropriate crash investigation are critical in reducing the road toll that is rapidly growing in much of the developing world, including Pakistan. This qualitative research explored the involvement of social and cultural factors (in particular, fatalism) in risky road use in Pakistan. The findings highlight a significant issue, previously unreported in the road safety literature, namely, the link between fatalistic beliefs and inaccurate reporting of road crashes. Method: Thirty interviews (one-to one) were conducted by the first author with police officers, drivers, policy makers and religious orators in three Pakistani cities. Findings: Evidence emerged of a strong link between fatalism and the under-reporting of road crashes. In many cases, crashes and related road trauma appear to go unreported because a crash is considered to be one’s fate and, therefore, beyond personal control. Fate was also implicated in the practice of reconciliation between parties after a crash without police involvement and the seeking and granting of pardon for a road death. Conclusions: These issues represent additional factors that can contribute to under-reporting of crashes and associated trauma. Together, they highlight complications involved in establishing the true cost of road trauma in a country such as Pakistan and the difficulties faced when attempting to promote scientifically-based road safety information to counteract faith-based beliefs.

A qualitative investigation of drug use among Pakistani road users

Background Statistics on drug use by Pakistani drivers are not available, yet considerable numbers of drivers are believed to be drug addicted. The National Drug Abuse Assessment 2006/07, conducted by the United Nation Office on Drugs and Crime and the Ministry of Narcotics Control Pakistan reported that opiate users numbered 628,000, of which 77%were chronic heroin abusers. Injecting drug users have reportedly doubled in the decade to 2006 and drug use has been linked with many major crashes involving professional drivers. Aims This study explored a broad range of risk taking behaviours of road users, including drug use. It also investigated associations between risky road use and fatalism and other cultural beliefs. Methods This paper reports findings relating to drug driving in the cities of Lahore, Rawalpindi and Islamabad. Thirty semi-structured interviews were conducted with bus, truck, and taxi drivers, policy makers and field police officers. Results Interviews suggested widespread use of illicit drugs, particularly among bus, truck and taxi drivers. Reasons for drug use included recreational purposes, stimulants during long driving episodes, and substance addiction. Furthermore, the use of drugs and any association with road crashes was generally viewed as linked to fatalism rather than to any fault of an individual. In other words, people did not believe there was an association between drug use and road crashes, even if they had personally experienced such. Police knowledge of drug use among drivers was evident, although there is no formal drug driving testing regime in Pakistan. Discussion and conclusions The substantial increase in drug use among the population in recent years highlights a significant public health challenge in Pakistan. This qualitative research, although recognized as not representative of the broader population, suggests that there is significant cause for concern about drug driving, especially among professional drivers, and a need for further investigation and intervention.

Carmen e a concepção trágica de Nietzsche: o amor retraduzido em natureza

O objetivo desta dissertação de Mestrado consiste fazer uma leitura da ópera Carmen, de Georges Bizet, com a ótica do conceito de trágico de Nietzsche. Privilegiamos o conceito abordado nas obras da maturidade, a partir da publicação de Assim falou Zaratustra, quando a visão trágica é contextualizada na fisiologia da arte, a filosofia é feita com o corpo, o texto da realidade é lido pela ótica da vontade de poder e o amor fati é a mais elevada concepção de amor. Após a apresentação destes conceitos, foi necessário investigarmos o contexto da amizade de Nietzsche e Richard Wagner para entendermos não só as afinidades pessoais, como também o projeto mútuo de renovação da arte alemã através do resgate do espírito trágico, que considerava a união entre filosofia e arte musical. O comprometimento de Wagner com os ideais ascetas, sua conversão ao dogma cristão, a composição de sua última ópera, Parsifal, e o não cumprimento dos ideais reformadores da arte após a inauguração do Teatro de Bayreuth, tudo isso decepcionou Nietzsche, levando-o a romper definitivamente esta amizade a partir de 1876. Seus escritos da maturidade são críticas severas ao wagnerianismo, e é nesta fase que o filósofo descobre Carmen, elogiando-a em cartas e também em O Caso Wagner, um panfleto de 1888, um de seus últimos escritos, onde reúne diversas críticas contra o compositor alemão. Estes elogios exaltam a postura de afirmação da vida e também o fatalismo presentes na obra de Bizet, o que a coloca diametralmente oposta às composições românticas wagnerianas. Tais adjetivações nos motivaram a pesquisar a possibilidade de Carmen ser considerada uma legítima expressão do trágico na Europa finisecular.

心理行为因素、免疫功能与乳腺癌的相关性研究

Present study consists of two experiments. In the first experiment, the relationship between psycho-behavioral factors, immune function and the stage of breast cancer was investigated. Fifty six postoperated hospitalized breast cancer patients with radiotherapy were used as the subjects. EPQ and MAC questionnaires were used to assess the patients' psycho-behavioral factors. Blood NK activation level and saliva IgA level were determined as the assessment of their immune function. It was found that the late stage breast cancer patients were more stable but more anxious in emotion. Patients with extrovert personality had higher NK activation and higher fighting spirit than did the patients with introvert personality. The patients with more fatalism had higher levels of saliva IgA and NK activation than did the patients with less fatalism. It was also found that the higher the level of saliva IgA, the higher the level of fighting spirit. In the second experiment, the effect of psycho-behavioral intervention on the immune function and the emotional state of these patients was studied. It was found that the psycho-behavioral intervention significantly increased the level of NK activation and tended to decrease the level of anxious preoccupation. The number of the patients who had to use medicine to increase peripheral blood white cells during radiotherapy was significantly decreased in patients with psycho-behavioral therapy when compared with the control group. Collectively, the data suggested that the immune function, cancer stage were related to the patients' psycho-behavioral factors and the psycho-behavioral intervention could improve the patients' immune function and emotional state.

Chernobyl: Living with Risk and Uncertainty

The nuclear accident in Chernobyl in 1986 is a dramatic example of the type of incidents that are characteristic of a risk society. The consequences of the incident are indeterminate, the causes complex and future developments unpredictable. Nothing can compensate for its effects and it affects a broad population indiscriminately. This paper examines the lived experience of those who experienced biographical disruption as residents of the region on the basis of qualitative case studies carried out in 2003 in the Chernobyl regions of Russia, Ukraine and Belarus. Our analysis indicates that informants tend to view their future as highly uncertain and unpredictable; they experience uncertainty about whether they are already contaminated, and they have to take hazardous decisions about where to go and what to eat. Fear, rumours and experts compete in supplying information to residents about the actual and potential consequences of the disaster, but there is little trust in, and only limited awareness of, the information that is provided. Most informants continue with their lives and do what they must or even what they like, even where the risks are known. They often describe their behaviour as being due to economic circumstances; where there is extreme poverty, even hazardous food sources are better than none. Unlike previous studies, we identify a pronounced tendency among informants not to separate the problems associated with the disaster from the hardships that have resulted from the break-up of the USSR, with both events creating a deep-seated sense of resignation and fatalism. Although most informants hold their governments to blame for lack of information, support and preventive measures, there is little or no collective action to have these put in place. This contrasts with previous research which has suggested that populations affected by disasters attribute crucial significance to that incident and, as a consequence, become increasingly politicized with regard to related policy agendas.

Eternity, knowledge, and freedom

This article addresses the problem of divine foreknowledge and human freedom by developing a modi?ed version of Boethius’ solution to the problem–one that is meant to cohere with a dynamic theory of time and a conception of God as temporal. I begin the article by discussing the traditional Boethian solution, and a defence of it due to Kretzmann and Stump. After canvassing a few of the objections to this view, I then go on to o?er my own modi?ed Boethian solution, according to which temporal reality is fundamentally dynamic, but truth is not. My claim is that there are eternally existing, tenseless propositions, with determinate truth values, but that these are made true by events that come into existence, and are not themselves eternal.

Donegall Pass: Towards a sustainable community:Chapter 5, Health and Wellbeing

Key Points

International research has long since established a gradient between health and socio-economic status and it is now clear that the social and physical context in which people live can have a negative influence on health.

Recent research has established an adverse effect on the health of people who remained in an area that had become more deprived over time

The mechanisms thought to influence health in declining communities include stress, loss of self-esteem, stigma, powerlessness, a lack of hope and fatalism.

These mechanisms are related to the concept of social capital, a resource produced when people co-operate for mutual benefit

Residents’ key concerns relating to the decline in the community are housing shortages which are perceived to be contributing to the breakdown of the family-based community, along with traffic; pollution; non-resident parking problems; a lack of youth facilities; and the influx of ethnic minorities who are less inclined to become involved with the community

In the Donegall Pass a dual process of outward migration and business development has resulted in a decline in social capital within the community which was particularly evident amongst the younger generations

People living in deprived areas, such as the Donegall Pass, that are adjacent to affluent areas, such as the new apartment developments surrounding the area, can often feel relatively more deprived due to such direct comparisons. Although relative deprivation was evident, peer comparisons with the Donegal Road/Sandy Row community were more commonly expressed

The area can be described as a ‘food desert’ as no affordable fresh grocery supplies are available within walking distance

Residents expressed mixed opinions about the future of the Donegall Pass including a common sense of resignation towards the decline in the core community

Many residents recognise the need for people to work together and gain empowerment in order to work with the authorities (i.e., the Housing Executive and the Council) towards progressive re-development that is in keeping with the aims of the community members, however, equally many were impervious towards these suggestions feeling that previous efforts had gone unrewarded.

Rejection, Shaming, Enclosure, and Moving On: Variant Experiences and Meaning Among Loyalist Former Prisoners:Variant Experiences and Meaning Among Loyalist Former Prisoners

This article unpacks the variant meanings, perceptions, and experiences of violent enactment and stigmatic shaming among loyalists with regard to rejection, harm, and masking. What we locate is a landscape of variable emotions, experiences, neutralization techniques, dependences, and embedded forms of fatalism as well as resilience. Attending to those alternate positions and well-beings is important in considering the capacity of re-integration and the presently uneven nature of it. In adopting an account-driven format we present and analyze how involvement in violent conflict can, on the one hand, provoke persistence and senses of transitional thinking and on the other engender rejection and related fatalistic attitudes.

Socioeconomic inequalities in attitudes towards cancer: An international cancer benchmarking partnership study

Socioeconomic status (SES) differences in attitudes towards cancer have been implicated in the differential screening uptake and the timeliness of symptomatic presentation. However, the predominant emphasis of this work has been on cancer fatalism, and many studies focus on specific community subgroups. This study aimed to assess SES differences in positive and negative attitudes towards cancer in UK adults. A population-based sample of UK adults (n=6965, age≥50 years) completed the Awareness and Beliefs about Cancer scale, including six belief items: three positively framed (e.g. 'Cancer can often be cured') and three negatively framed (e.g. 'A cancer diagnosis is a death sentence'). SES was indexed by education. Analyses controlled for sex, ethnicity, marital status, age, self-rated health, and cancer experience. There were few education-level differences for the positive statements, and overall agreement was high (all>90%). In contrast, there were strong differences for negative statements (all Ps<0.001). Among respondents with lower education levels, 57% agreed that 'treatment is worse than cancer', 27% that cancer is 'a death sentence' and 16% 'would not want to know if I have cancer'. Among those with university education, the respective proportions were 34, 17 and 6%. Differences were not explained by cancer experience or health status. In conclusion, positive statements about cancer outcomes attract near-universal agreement. However, this optimistic perspective coexists alongside widespread fears about survival and treatment, especially among less-educated groups. Health education campaigns targeting socioeconomically disadvantaged groups might benefit from a focus on reducing negative attitudes, which is not necessarily achieved by promoting positive attitudes.

What a girl's gotta do: the labor of the biopolitical celebrity in austerity Britain

This article debunks the widespread view that young female celebrities, especially those who rise to fame through reality shows and other forms of media-orchestrated self-exposure, dodge “real” work out of laziness, fatalism, and a misguided sense of entitlement. Instead, the authors argue that becoming a celebrity in a neoliberal economy such as that of the United Kingdom, where austerity measures disproportionately disadvantage the young, women, and the poor, is not as irregular or exceptional a choice as previously thought, especially since the precariousness of celebrity earning power adheres to the current demands of the neoliberal economy on its workforce. What is more, becoming a celebrity involves different forms of labor that are best described as biopolitical, since such labor fully involves and consumes the human body and its capacities as a living organism. Weight gain and weight loss, pregnancy, physical transformation through plastic surgery, physical symptoms of emotional distress, and even illness and death are all photographically documented and supplemented by extended textual commentary, usually with direct input from the celebrity, reinforcing and expanding on the visual content. As well as casting celebrity work as labor, the authors also maintain that the workings of celebrity should always be examined in the context of wider cultural, social and real economies.

The Big Society and the conjunction of crises: Justifying welfare reform and undermining social housing

This article considers the idea of the ‘Big Society’ as part of a long-standing debate about the regulation of housing. Situating the concept within governance theory, the article considers how the idea of the Big Society was used by the UK coalition government to justify a radical restructuring of welfare provision. The fundamental rationale for this transformation was that the UK was forced to respond to a conjunction of crises in morality, the state, ideology and economics. Representing a fundamental departure from earlier attempts at welfare reform, the government has undertaken a reform programme which has had a severe effect on the social housing sector. The article argues that the result has been a combination of libertarianism and authoritarianism, alongside an intentionally more destructive combination of stigmatization and fatalism. The consequence is to undermine the principle of social housing which will not only prove detrimental for residents but raises significant dilemmas for those working in the housing sector.

Do Spirituality and Faith Make a Difference? Report from the Southern European Psycho-Oncology Study Group

OBJECTIVE: In the last decade, some attention has been given to spirituality and faith and their role in cancer patients' coping. Few data are available about spirituality among cancer patients in Southern European countries, which have a big tradition of spirituality, namely, the Catholic religion. As part of a more general investigation (Southern European Psycho-Oncology Study--SEPOS), the aim of this study was to examine the effect of spirituality in molding psychosocial implications in Southern European cancer patients. METHOD: A convenience sample of 323 outpatients with a diagnosis of cancer between 6 to 18 months, a good performance status (Karnofsky Performance Status > 80), and no cognitive deficits or central nervous system (CNS) involvement by disease were approached in university and affiliated cancer centers in Italy, Spain, Portugal, and Switzerland (Italian speaking area). Each patient was evaluated for spirituality (Visual Analog Scale 0-10), psychological morbidity (Hospital Anxiety and Depression Scale--HADS), coping strategies (Mini-Mental Adjustment to Cancer--Mini-MAC) and concerns about illness (Cancer Worries Inventory--CWI). RESULTS. The majority of patients (79.3%) referred to being supported by their spirituality/faith throughout their illness. Significant differences were found between the spirituality and non-spirituality groups (p ≤ 0.01) in terms of education, coping styles, and psychological morbidity. Spirituality was significantly correlated with fighting spirit (r = -0.27), fatalism (r = 0.50), and avoidance (r = 0.23) coping styles and negatively correlated with education (r = -0.25), depression (r = -0.22) and HAD total (r = -0.17). SIGNIFICANCE OF RESULTS: Spirituality is frequent among Southern European cancer patients with lower education and seems to play some protective role towards psychological morbidity, specifically depression. Further studies should examine this trend in Southern European cancer patients.

Combien de temps le développement peut-il encore durer ?

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