Life Dilemmas Research Articles

Foot Barriers in Patients With Early Rheumatoid Arthritis: An Interview Study Among Swedish Women and Men.

Foot impairments are related to reduced mobility and participation restrictions in daily activities in patients with established rheumatoid arthritis (RA). The new biologic medications are effective and reduce disease activity, but not disability to the same extent. Foot impairments are assumed to be related to participation restrictions also in patients with early RA, diagnosed after the introduction of biologic medications. Knowledge of foot impairments needs to be explored further after the introduction of biologic disease-modifying antirheumatic drugs (bDMARDs). The aim of this study was to explore the patients' perspective of foot impairments related to early RA. The sample included 59 patients (ages 20-63 years) who were interviewed about participation dilemmas in daily life using the critical incident technique. The interviews were audio-recorded and transcribed. Data related to foot impairments were extracted and analyzed thematically. A research partner validated the analysis. Patients with early RA described a variety of participation restrictions related to foot impairments: foot hindrances in domestic life, foot impairments influencing work, leisure activities restricted by one's feet, struggling to be mobile, and foot impairments as an early sign of rheumatic disease. There is a need to focus on foot impairments related to early RA, and for health care professionals to understand these signs. A suggestion for future research is to conduct a longitudinal followup of foot impairment related to medication, disease activity, and disability in patients diagnosed after the introduction of bDMARDs.

‘Where am I in this story?’ – listening to activist women writers

This study discusses the dynamic roles of activist women in militarized societies. It offers an analysis of the perspectives of Israeli activist women regarding their roles as women activists and writers. In their non-fiction writings, these activist women voice their resistance and document both their everyday lives and political perspectives about the Israeli-Palestinian conflict and their socio-political activism and resistance to the Israeli occupation. These women were interviewed regarding their perspectives and struggles. The interviews were analysed by applying narrative analysis – the ‘Listening Guide’ methodology – to explore their various voices and narratives. By using this methodology, this study sought to uncover additional knowledge regarding women’s forms of resistance in militarized societies. We emphasize the importance of women citizens’ voices, narratives and points of view by presenting activist women’s critical insights on activism, the Israeli-Palestinian conflict and literature. Their curiosity, agency, critical perspectives, and resistance can be viewed as counter-narratives that de-centre Israeli hegemonic masculinity and demand a critique of the national and militarized ideology. Our article seeks to demonstrate the importance of women’s perspectives, everyday life experiences, dilemmas and struggles in a reality of conflict and war.

Ama Ata Aidoo’s Diagnose and Representation of the Dilemma of the African American Diaspora in her play Dilemma of A Ghost

The research investigates in details about the influence of cultural differences in Postcolonial Ghana as presented in Ama Ata Aidoo's Dilemma of a Ghost. The play centers on the cross cultural marriage of young couple; Ato Yawson, a Ghanaian who recently completed his studies in the United States and returns home, and Eulali, his African American bride. Ghanaian playwright Ama Ata Aidoo expresses the consciousness of the diaspora of Ato Yawson and his wife and the final effort of Yawson’s mother to find a compromise. The husband is caught between the challenging demands of his wife and his family, He feels torn and irresolute as the folkloric ghost in the children's song in the play. Aidoo has a strong historical and political awareness of Africa's colonial past and post-colonial present, and the problems facing an African woman in Africa and outside it. She is like a physician, diagnoses the symptoms of the troubled postcolonial age in Africa. In her use of Dilemma tale technique, she raises difficult questions without easy solution leaving her readers to contemplate about. She calls for an action to resolve the painful dilemma of African life in a world of change where the past and present, tradition and modernity suffer a fierce conflict. The aim of the research is to prove that according to the concept of compensation there is neither absolute gain nor absolute loss for with every loss there is again and with every gain there is a loss. Without the concept of compromise the dilemma of diaspora will lead to catastrophic results.

Correlation research of clinical nurses' quality of life with sleep quality and job burnout in classIII grade A hospitals in Xuzhou

Objective To explore the correlation of nurses' quality of life with sleep quality and their job burnout in class Ⅲ grade A hospitals, and to identify the high risk factors affecting nurses' quality of life, so as to provide constructive suggestions. Methods From September 2015 to January 2016, totally 460 nurses working in class Ⅲ grade A hospitals of Xuzhou were investigated by self-administered questionnaire using the Pittsburgh Sleep Quality Index (PSQI) , the Maslach Burnout Inventory (MBI) and the World Health Organization quality of life instrument's BREF (WHOQOL-BREF) . The data was analyzed by SPSS17.0 statistical software, and measurement data use t-test. The multivariate linear regression equation model took PSQI and MBI entries as independent variables, and took the dimensions of WHOQOL-BREF as the dependent variable, and used the stepwise method to run the equation. Results A total of 460 questionnaires were issued and 400 valid were recovered. The effective recovery rate was 86.9%. Compared with respective norm, the scores of PSQI (7.18±3.47) , emotional exhaustion (23.99±12.45) and depersonalization (8.20±5.97) dimension of MBI were higher, and the differences were statistically significant (t=38.846, 36.154, 25.737; P<0.001) . The score of personal accomplishment dimension of MBI and all four areas in WHOQOL-BREF were lower than norm, and the differences were statistically significant (P<0.001) . Regression analysis showed that subjective sleep quality, sleep time in PSQI and emotional exhaustion area, personal accomplishment area of MBI had significant effects on nurses' quality of life (P<0.05) . Conclusions The quality of sleep and quality of life of clinical nurses in class Ⅲ grade A hospitals is poor, and their job burnout is strong. It suggests that solving nurses' working life dilemma should start from the high risk factors which have great influence on it, so as to improve nurses' quality of life. Key words: Nurses; Sleep quality; Job burnout; Quality of life; Correlation

Editor's Note

Editor's Note Rebecca Rovit, Associate Professor In his seminal essay, "Thick Description: Toward an Interpretive Theory of Culture" (1973), Clifford Geertz cautioned that to counter the "ever-present" danger of losing touch with the realities of our times, cultural analyses must engage what he referred to as "the hard surfaces of life—with the political, economic, stratificatory realities within which men are everywhere contained—and with the biological and physical necessities on which those surfaces rest."1 Forty-five years later, many of us in theatre and performance studies have adopted Geertz's call for social engagement, relying on interdisciplinarity to inform our scholarly analyses and our performance practices. Moreover, the visual and performing arts provide us with a natural site for social action. In this first issue of 2018 I am pleased to feature an array of authors whose articles—particularly in our special section on Dramatic Theory—resonate with our turbulent times. As a prelude to our guest-edited section, two authors consider the theoretical and practical potential of the dramatic work and its implications for performance. In "'Ulysses' Craft': Euripides and Levinas," Dylan Shaul takes up ancient strife in his examination of the satyr play genre, using the work of Emmanuel Levinas to explore the work of art as a site for ethical transformation. The art work also serves as a locus for a series of negotiations: between self and other, the individual and the masses, being and becoming, and war and peace. Significantly, the author emphasizes the ontological drama that Levinas establishes with the notion of hospitality in welcoming the other in a face-to-face encounter between Self and Other. Amy Steiger shifts our focus from the theoretical to the practical, while also incorporating the experiential in "Paradoxical Sleep and Flights of Imagination: Sleep Rock Thy Brain and the Performance of Research." She elucidates the transdisciplinary process by which a public university collaborated with the Actors Theatre of Louisville (2013) to produce a triptych of plays about sleep. Informed by the insights of sleep scientists and psychologists, the performance project created what the author suggests could be a model for new forms of public scholarship in theatre. Further, the Louisville artistic experiment exemplifies how communities can provide networking opportunities for institutions (including universities) and businesses to forge working relationships across the arts and STEM fields. When Geertz advocated that we create meaningful frameworks in which to examine aspects of social action, he suggested that such an examination would "plunge" us into "the existential dilemmas of life."2 At the core of our special section, titled "Dramatic Theory?" and guest-edited by Eero Laine, lies the idea of theatre as a site for cultural and theoretical intervention. I would like to acknowledge those people who continue to make the publication of JDTC possible. Thank you to the College of Arts and Sciences for your sustained support of the journal. My gratitude also goes to Michelle Heffner Hayes, Chair of the newly-formed (as of 1 July) Department of Theatre & Dance. New to our [End Page 1] editorial staff is Jocelyn Buckner, who begins her two-year term as Book Review Editor with this issue. I also am pleased to welcome Chris Hall as our new Managing Editor. Chris is a second-year doctoral student in the English Literature Department at KU. A recipient of the Hall Center for the Humanities Doctoral Fellowship, Chris researches modernism in light of imperialism and colonialism. His dissertation examines modernity through the lens of "worlds"—frameworks for discourses, material realities, and art—in order to erode oppressive boundaries of separation and difference. Finally, I extend my heartfelt thanks to each of you who so willingly has reviewed for the journal. Your active engagement in the peer-review process helps us to keep our standards high in publishing new scholarship in each issue. We encourage new authors and returning ones to send your submissions to jdtc@ku.edu. My four years as Editor will come to a close with the Fall 2018 issue. Be on the lookout for our announcement of my successor. In the meantime, we at JDTC wish each of you a happy and productive summer. Rebecca Rovit, Associate...

A espiritualidade e a medicina integrativa no contexto da saúde integral do ser humano

As pesquisas apontando a relação entre saúde e espiritualidade vêm crescendo de forma progressiva. O objetivo deste trabalho é fazer as devidas diferenciações conceituais entre os termos religião, religiosidade e espiritualidade e apresentar sua relevância no contexto da saúde física e psíquica em diálogo com o novo modelo médico, a medicina integrativa. A metodologia utilizada para a construção deste trabalho foi a revisão bibliográfica de literatura. Os resultados apontam que há diferenciações nos termos religião, religiosidade e espiritualidade. A medicina integrativa, mediante a visão holística do ser humano, preconiza uma abordagem multidisciplinar e interdisciplinar no processo de cura dos pacientes. Por isso foi considerado o coping religioso como estratégia de enfrentamento nos mais variados dilemas da vida. Conclui-se que a defi nição contemporânea sobre religião/religiosidade/espiritualidade se volta mais para a vivência da religião do que para os seus aspectos institucionais. A espiritualidade não institucional, desvinculada das tradições religiosas, poderá ser benéfica tanto para o físico como para a psique humana. Tal assertiva contribuirá para o processo de humanização do indivíduo e com o diálogo entre outros campos do saber, dentre esses, o novo modelo médico, a medicina integrativa.

重探張愛玲小說裏的病態身體———以《花凋》、《紅玫瑰與白玫瑰》、《小團圓》爲主

LANGUAGE NOTE | Document text in Chinese; abstract also in English.&#x0D; 蘇珊•桑塔格（Susan Sontag）認爲，疾病是内在精神狀態通過身體說出的語言，是一種自我表達。張愛玲（1920—1995）小說的文本分析車載斗量，疾病書寫在“張學”裏不是新話題。曹七巧“閣樓上的瘋女人”（The Madwoman in the Attic）形象，肺病隱喻，歇斯底里症候，或厭食症狀、子宫病變，均是學者關注焦點。總的來說，肺結核、歇斯底里、瘋狂，應該是張愛玲小說内的疾病書寫最常被論及的面向，當然，這些也是中國現代文學裏慣見的幾種病態。而本文則希望能擴及張愛玲小說内其他尚未被論說圓滿的病體書寫。&#x0D; 因此，本文主要透過《花凋》裏的肺癆、《紅玫瑰與白玫瑰》裏的霍亂與便秘、《小團圓》裏的厭食症與性愛疼痛，探討張愛玲小說裏的病態身體（morbidbody）的三種樣貌：消耗與醜怪的身體、堵塞與自囚的身體、内傷與自棄的身體，以及其所彰顯的意義、在小說美學上的功能。談疾病書寫而格外側重身體，是因爲疾病必須在身體顯現摧枯拉朽之力，才能暗示、側寫出人物的身心變化與生命困局；進一步也能探究，小說人物什麽樣的遭遇與什麽樣的疾病會被聯繫起來。借助歷史材料，並深化小說文本解讀，得以見出張愛玲小說裏所生産出的病態身體，並非孤立存在，而是鑲嵌於歷史、社會與性别的圖景内。&#x0D; Susan Sontag argues that illness is the internal spiritual status that becomes a language spoken through the body, and is therefore a form of self-expression. There have been plenty of studies of Eileen Chang’s (1920-1995) novels, and the discussion of narratives on illnesses in her works is not new. Cao Qiqiao, the Madwoman in the Attic depicted as a patient of tuberculosis with symptoms of hysteria, anorexia and uterine diseases, has long been a focus of recent scholarship. These are certainly common illnesses found in modern Chinese literature. The present essay, however, is an attempt to discuss Chang’s writing on illnesses that have not yet been studied.&#x0D; Hence, the present research focuses on illnesses such as tuberculosis in The Withering Flower, cholera and constipation in The Red Rose and the White Rose, and anorexia and dyspareunia in Little Union. It explores three types of morbid bodies in Chang’s novels: exhausted and ugly bodies; confined and self-imprisoned bodies; and internally injured and self-abandoned bodies; and discusses their significance as well as their aesthetic functions. The description of the body is essential in the discussion of narratives of illnesses because by means of its formidable power illness functions in implying or indirectly depicting the protagonist’s changes in physical and psychological condition as well as her life dilemmas. Furthermore, the research explores the connection between certain encounters and certain diseases. Making use of historical sources, the analysis of texts may become more in-depth; we see that the morbid bodies in Chang’s novels by no means exist in isolation but are imbedded in a contextual picture of history, society, and gender.

Thin-Slice Measurement of Wisdom.

Objective Measurement of Wisdom within a short period of time is vital for both the public interest (e.g., understanding a presidential election) and research (e.g., testing factors that facilitate wisdom development). A measurement of emotion associated with wisdom would be especially informative; therefore, a novel Thin-Slice measurement of wisdom was developed based on the Berlin Paradigm. For about 2 min, participants imagined the lens of a camera as the eyes of their friend/teacher whom they advised about a life dilemma. Verbal response and facial expression were both recorded by a camera: verbal responses were then rated on both the Berlin Wisdom criteria and newly developed Chinese wisdom criteria; facial expressions were analyzed by the software iMotion FACET module. Results showed acceptable inter-rater and inter-item reliability for this novel paradigm. Moreover, both wisdom ratings were not significantly correlated with Social desirability, and the Berlin wisdom rating was significantly negatively correlated with Neuroticism; feeling of surprise was significantly positively correlated with both wisdom criteria ratings. Our results provide the first evidence of this Thin-slice Wisdom Paradigm’s reliability, its immunity to social desirability, and its validity for assessing candidates’ wisdom within a short timeframe. Although still awaiting further development, this novel Paradigm contributes to an emerging Universal Wisdom Paradigm applicable across cultures.

Negotiations of Blame and Care among HIV-positive Mothers and Daughters in South Africa's Eastern Cape.

Research delineates two epidemiological categories among HIV-positive adolescents: those who contract the virus sexually and those who inherit it as infants. In this article, we are interested in how tacit inferences about adolescents' mode of infection contribute to their experiences of HIV-related blame, and their ability to achieve care, in their intimate, everyday settings. The analysis arises from ethnographic research with 23 HIV-positive adolescents living in South Africa's Eastern Cape. From these, we draw particularly on the narratives of four HIV-positive teenage girls and their HIV-positive mothers. The article explores the social stakes entailed in ascriptions of adolescents' mode of infection, particularly in terms of how blame was allocated between mothers and daughters. It further considers how these families have sought to negotiate repudiation and thereby sustain intergenerational care. The article furthers limited research on the life projects and dilemmas of this HIV-positive adolescent cohort.

Exploring the work–life challenges and dilemmas faced by managers and professionals who live alone

This article aims to question the dominant understanding of work–life balance or conflict as primarily a ‘work–family’ issue. It does this by exploring the experiences of managers and professionals who live alone and do not have children – a group of employees traditionally overlooked in work–life policy and research but, significantly, a group on the rise within the working age population. Semi-structured interviews with 36 solo-living managers and professionals were carried out in the UK, spanning a range of occupations. In addition to previously identified work–life issues, four themes emerged that were pressing for and specific to solo-living managers and professionals. These are articulated here as challenges and dilemmas relating to: assumptions about work and non-work time; the legitimacy of their work–life balance; lack of support connected to financial and emotional well-being; and work-based vulnerabilities.

Business Student Perception Towards Ethics: An Exploratory Study

In regard to ethics and values, nowadays corporate scenario also demands business ethics which will guide the emerging professionals to exercise this ethical domain in their professional lives. The children of present generation do not know about their culture, traditions, values, ethics etc. This is one of the reasons why the content related to ethics and values is included in the curriculum of their professional studies. The objective of the present paper is to study the perception of business students regarding ethics and values. The role of ethics and values in a students life is very important as it strongly affects their future, career, growth, professional behaviour and helps them learn how to tackle ethical dilemmas in personal and professional life. The data for the study had been collected from the undergraduate (commerce, management, engineering, arts, and science) and postgraduate (commerce, management, engineering, arts, and science) students of the private university situated in the state of Uttar Pradesh. The collected data was analysed with the help of statistical technique such as factor analysis, T-test and regression analysis. The results revealed that awareness about ethics and values is an important factor accessed by all the respondents of the study.

Withstanding the Winds of Change? Literary Representations of the Gulf War and Its Impacts on Saudi Society

This article argues that the 1991 Gulf War had a deep transformative effect on Saudi Arabia. It aims to analyze the extent to which this war brought about major ideological changes to a society seemingly deemed unchangeable. Through the study of three Saudi novels which drew on this war as a source of creative and political inspiration, this study brings to life Saudi people's discussions, dilemmas, and reactions to the crumbling of the edifice of Arab unity and the emergence of “America” in its place as the “savior” from the evil of Saddam Hussein. We contend that despite resistance from various conservative elements of Saudi society, the winds of change brought by this war could not be resisted. The novels under study skillfully portray the events of this war not as battlefield accounts, but as accounts of a society wrestling with an irresistible wind of change.

The Caribbean Medical Center case: Marketing decision-making for hospitals facing customer attrition

Within today's cut throat business environment, hospitals, like any other business, must apply strategic managerial practices as well as modern marketing principles in order to remain competitive. Thanks to globalization, this perspective applies now for all private hospitals, from large high-end hospitals in developed countries, to low income small to medium sized hospitals in the developing world. This case study offers instructors and readers alike a chance to think critically about a real life dilemma in hospital management, in which the general manager of a private medical center in Panama must decide where to focus the center's limited resources after losing their biggest client. To solve this problem, the general manager must apply sound marketing strategies in order to determine the best course of action. Through the analysis of this case study, readers can conduct a segmentation exercise, establish the medical center's value proposition, conduct a competitive analysis, and define the hospital's strategic positioning. This case study uses information primarily acquired through in-depth interviews with the hospital's senior management, staff, members of their executive committee, and members of the medical community in Panama; an on-site visit was also performed.

Collusions and Imbrications: Life Writing and Colonial Spaces

ABSTRACTThis essay offers an investigation into the characteristics or distinctive features of life writing in colonial and postcolonial spaces. Among the examples of life writing here considered are George Lamming’s In The Castle of My Skin and C. L. R. James’s Beyond a Boundary, and, less often treated in this context, works by Benjamin Franklin and James Joyce; stress is placed on the importance of American literature for early articulations of the problems and dilemmas of postcolonial life writing. Further emphasis is laid on place, and on the need for bibliographical research into the place of publication of works written in or concerned with colonial spaces.

Nurturing moral competence in university students via a credit-bearing subject

AbstractMoral competence is an important dimension in healthy adolescent development and effective leadership. In this paper, a lecture attempting to nurture the moral competence of university students in Hong Kong is described. There are several parts to this lecture. In the first part, moral dilemmas in real life and hypothetical situations are introduced. Second, conceptual frameworks on moral judgment are outlined. In the third part, the relationship between morality and leadership is addressed. In the next part, strategies to promote moral development are discussed. Finally, conclusions and reflections by the students are carried out. In the lecture, students are invited to have personal reflections on their moral competence and integrity in relation to their real life context.

The Third Man: comparative analysis of a science autobiography and a cinema classic as windows into post-war life sciences research.

In 2003, biophysicist and Nobel Laureate Maurice Wilkins published his autobiography entitled The Third Man. In the preface, he diffidently points out that the title (which presents him as the ‘third’ man credited with the co-discovery of the structure of DNA, besides Watson and Crick) was chosen by his publisher, as a reference to the famous 1949 movie no doubt, featuring Orson Welles in his classical role as penicillin racketeer Harry Lime. In this paper I intend to show that there is much more to this title than merely its familiar ring. If subjected to a (psychoanalytically inspired) comparative analysis, multiple correspondences between movie and memoirs can be brought to the fore. Taken together, these documents shed an intriguing light on the vicissitudes of budding life sciences research during the post-war era. I will focus my comparative analysis on issues still relevant today, such as dual use, the handling of sensitive scientific information (in a moral setting defined by the tension between collaboration and competition) and, finally, on the interwovenness of science and warfare (i.e. the ‘militarisation’ of research and the relationship between beauty and destruction). Thus, I will explain how science autobiographies on the one hand and genres of the imagination (such as novels and movies) on the other may deepen our comprehension of tensions and dilemmas of life sciences research then and now. For that reason, science autobiographies can provide valuable input (case material) for teaching philosophy and history of science to science students.

Ambiguities in organizations and the routines of behavior and change

Purpose– The aim of this article is threefold: the primary aim is conceptual by outlining two ideal-typical ideas about organizational life. These models offer rival ideas about how organizations balance seemingly conflicting patterns of behaviour and change in everyday life. The second ambition of the article is to outline a theoretical approach of organizational life arguing that even fairly loosely coupled organizations may be profoundly patterned by everyday routines as much as by ambiguity. The third and final ambition is to offer empirical illustrations from organizations that are often considered as archetypes of loose coupling and ambiguities: jazz orchestras and university organizations. The empirical discussion, however, illustrates that behaviour and change in these organizations are coined by routines and rules.Design/methodology/approach– Two common dynamics often observed in organizations are highlighted: first, organizations viewed as sets of formal structures and routines that systematically bias organizational performance and change, and secondly, organizations as loosely coupled structures that enable improvisation with respect to organizational performance and change. How organizations live with and practice such seemingly contradictory dynamics is empirically illuminated in two types of organizations that are seldom analysed in tandem – university organizations and jazz orchestras. Drawing on contemporary research on these seemingly contradictory laboratories of organizational analysis, some observations are highlighted that indeed are common to both types of organizations. Furthermore, it is argued that lessons may be drawn from organizations where turbulence is common and where seemingly un-organized processes are quite regular. University organizations and jazz orchestras represent such types of organizations.Findings– First, the degree of ambiguity in organizations is a matter of degree, not an either/or, and that the uncertainty and spontaneity observed in organizational behaviour and change is more patterned than often assumed (see Heimer and Stinchcombe, 1999; Strauss, 1979). As such, organization theory may be a useful extension of the garbage can model, suggesting that streams in decision-making processes may be systematically pre-packed and patterned by the availability of access and attention structures (Cohen et al., 1976). Secondly, scholarship in organizational studies needs to do away with over-simplistic dichotomies when facing complex realities. This challenge is equal for studies of public sector organizations as for scholarship in business and management. Organization studies often face the tyranny of conceptual dichotomies (Olsen, 2007). This article suggests that the distinction between loose and tight coupling in organizations, as between improvisation and pre-planned activities in organizations, face the danger of shoehorning complex data into simple categories. Originality/value – How organizations live with and practice seemingly contradictory dynamics is empirically illuminated in two types of organizations that are seldom analysed in tandem in organizational studies – university organizations and jazz orchestras. These conflicting organizational dynamics pinpoint one classical dilemma in university and jazz life beleaguered on the inherent trade-off between instrumental design and the logic of hierarchy on the one hand, and individual artistic autonomy and professional neutrality on the other. “[T]he purpose of developing the jazz metaphor is to draw out the collaborative, spontaneous and artful aspects of organizing in contradiction to the engineered, planned and controlled models that dominate modern management thoughts” (Hatch, 1999, p. 4). This dilemma highlights competing understandings of organizational life, of institutional change, and of what the pursuit of organizational goals ultimately entails.

Freedom Dreams

Contemporary African-American scholars across the humanities and social sciences share a preoccupation with posing big questions about the dilemmas of black life in the United States. Under the historic presidency of Barack Obama, the relevance of tackling African-American thought and action in the post–civil rights period has only grown. One of the leading voices among a cohort of black political scientists considering these themes has been Michael C. Dawson, whose new book, Blacks In and Out of the Left, takes on the question of strategy for contemporary left black politics. Dawson has long been concerned with the potential for solidarity within a black American population increasingly diverse in class and culture. In Behind the Mule: Race and Class in African-American Politics, which appeared in 1994, he explored how African Americans retained a strong sense of group identificationdespite becoming more economically differentiated.

Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project)

Purpose: To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. Methods: A total of 48 patients, aged 20–63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Results: Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Conclusions: Participation restrictions in today’s RA patients are complex. Our results underline that the health care needs to be aware of the patients’ own preferences and goals to support the early multi-professional interventions in clinical practice.Implications of RehabilitationToday’s rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities.The health care need to be aware of the patients’ own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.

Palomino: Clinton Jencks and Mexican-American Unionism in the American Southwest by James J. Lorence (review)

Reviewed by: Palomino: Clinton Jencks and Mexican-American Unionism in the American Southwest by James J. Lorence Jeffrey Helgeson Palomino: Clinton Jencks and Mexican-American Unionism in the American Southwest. By James J. Lorence. (Champaign: University of Illinois Press, 2013. Pp. 288. Illustrations, notes, bibliography, index.) This biography of labor activist and scholar Clinton Jencks is an important addition to the work of James J. Lorence, an eminent historian of labor in the Southwest. Published posthumously, the volume is not so much a capstone to Lorence’s career as it is further evidence of the critical perspective—and the deep and abiding love—Lorence brought to the study of labor history in in the Southwest. In telling Jencks’s life story, Lorence reveals how the often-overlooked efforts of leftist activists in the region not only survived the reactionary years after World War II but managed to bring a mix of radicalism and pragmatic organizing to the labor movement, the Mexican American civil rights struggle, and even the otherwise conservative world of academic economists in the Southwest. Lorence describes Jencks as someone rooted in early life in a moral indictment of inequality through his exposure to the history of the radical Western Federation of Miners and a sense of “Christian duty” (4). Jencks came to a leftist critique of the status quo in college in Boulder, Colorado, going further than most college students by committing himself to the cause of equality across race, class, and gender. Throughout the book, Lorence emphasizes the hybrid and independent nature of Jencks’s politics. A “Christian Communist” (xviii), Jencks worked to empower rank and file workers—and their families—and to argue for the expansion of the benefits of the American welfare state to the otherwise excluded. Lorence’s biography helps explain how, in the context of anticommunist repression after World War II, a pragmatic Christian moralist like Jencks could be radicalized and become a key organizer in a kind of underground world of the Southwest’s interracial left. Clinton Jencks and his wife Virginia Derr Jencks were instrumental in the organization of Local 890 of the International Union of Mine, Mill and Smelter Workers in New Mexico, and in the landmark 1951 strike against the Empire Zinc Company. The struggle has been immortalized in the 1954 film, Salt of the Earth, produced in a collaborative effort between blacklisted Hollywood film makers, the miners themselves, and Clinton and Virginia Jencks. Lorence provides important contextual background regarding how Jencks came to earn the miners’ trust—the miners dubbed Jencks the “Palomino,” a title of deep respect—and how (like the characters in the film) Jencks overcame his paternalistic attitudes toward women despite himself. For those familiar with Salt of the Earth and Lorence’s Suppression of Salt of the Earth (1999), this biography adds greater depth of insight into what it meant to combine pragmatic organizing and radical ideology in social movements in the Southwest after World War II. Jencks’s life story raises important questions about the tensions between individual leadership and collective action, the tensions between traditional gender values and the impulse to empower women as leaders, and the difficulties of building a multiracial community. Lorence’s colleague Harlan Grinde has done us all a favor in bringing this biography to light after his friend’s death. Yet the reader cannot help but feel that the manuscript could have used one more deep revision by Lorence himself. As it is, the narrative tends to be repetitive and not as subtle as it might be. Moreover, though Jencks was skeptical regarding the value of individual [End Page 98] biographies, Lorence remained committed to this project as an example of an activist who continually reinvented himself to persist in the work for a communal vision of social justice. The reader cannot quite escape the feeling that Jencks was right that the book would have been stronger if framed as a collective biography. Still, Jencks’s biography will speak to anyone interested in the dilemmas of a radical life, the struggles of married couples to live out egalitarian principles, and the history of labor and civil rights activism and the repression of the New Left in...