Pluralism and ethnic conflict in Tanzania's arid lands: the case of the Maasai and the WaArusha

In Tanzania, the Maasai and Waarusha tribes are experiencing conflict because differences in their modes of productions and economic strategies undermine the peaceful coexistence that they have enjoyed since the 18th century. The Maasai are pastoralists, while the Waarusha are agricultural subsistence farmers who are encroaching on the best pasture lands. A sketch of the history of the two groups shows that the Maasai reached the peak of their land holding in 1880 before the arrival of European colonists who seized land and restricted the Maasai to a semi-arid reserve but allowed the Maasai to remain an autonomous and powerful group. The Waarusha began encroaching on Maasai land after independence due to land and population pressure. While closely tied, each group looks down on the other, and Maasai ascendancy has given way to Waarusha challenges. After independence, the tribal and ethnic rule that was protected by the colonial system was disrupted to allow for increased internal migration and new patterns of settlement. The rights of land ownership were transferred from tribes to the State, allowing privileged groups to benefit. The Waarusha began to engage in illegal land-grabbing and to encroach on the Maasai preserve using legal and illegal means. The Maasai view land as collective property and have had difficulty retaining title of traditional lands in the face of population pressure. This loss of grazing land has forced the Maasai into a mixed economy that depends upon agricultural production as well as livestock production. In the meantime, the Waarusha have deliberately sought political office to gain power to secure their holdings. Immediate action is needed to produce 1) a policy on spontaneous settlement, 2) an immediate adjustment of legal procedures for land acquisition, 3) a land tenure policy that equally emphasizes agricultural and livestock production, and 4) controls on undue expansion of subsistence agriculture into semi-arid rangelands.     

The new health care civilization: integration of physician land and manageria

Changes occurring in health care demand that physicians expand their professional knowledge and skills beyond the medical and behavioral sciences. Subjects absent from traditional medical education curricula, such as the economics and politics of health care, practice management, and leadership of professional organizations, will become important competencies, particularly for physicians who serve in management roles. Because physicians occupy a central role in planning and allocating medical care services and other health care resources, they must be better prepared to work with other health care professionals to create a new civilization, even if this means leaving the cloistered domain of "physician land" to serve as interface professionals between the delivery of medical services and the management of health care. Our research findings and conclusions strongly suggest that economic, management, and leadership competencies need to be incorporated into the professional development of physicians, especially in postgraduate and continuing education curricula.     

IOM/UNFPA project on emigration dynamics in developing countries

The author briefly reviews a special section of papers in this issue of International Migration. The papers focus on aspects of a project on emigration dynamics in developing countries.     

Freud's “Anna O.”: Social work's Bertha Pappenheim

The story of Anna O. has loomed large in psychoanalytic history, but few social workers know that the young woman, who was so influential in the development of Freud's thinking, became a pioneer social worker in Germany. The story of the transformation of the troubled young woman, who was actually Joseph Breuer's patient, is the focus of this paper. In addition, some of the facts of the case are discussed as social constructions. Anna O./ Bertha Pappenheim participated in the creation of the talking cure and eventually went on to be a leading feminist, developer of social programs for women, and social reformer.     

Analgesia produced in women by genital self-stimulation

This study investigated the relative effectiveness of specific genital regional self-stimulation in elevating pain thresholds. Anecdotal reports in humans suggest that sexual activity and orgasm decrease a wide variety of human responses to pain and touch, but the phenomenon has not been evaluated objectively. Two types of self-stimulation, pressure and pleasurable, were applied by 10 women to the anterior vaginal wall, the posterior vaginal wall, and the clitoris. Significant increases in pain thresholds but not tactile thresholds occurred when pressure stimulation was applied to the anterior wall of the vagina or when "pleasurable" self-stimulation was applied to any of the three areas. Tactile thresholds were not significantly affected by any genital stimulation condition. However, there was a significant increase in tactile threshold but not pain thresholds in the distraction control condition. On the basis of these findings, we conclude that (a) a sensation of pleasure evoked by genital stimulation can elevate pain thresholds, (b) these pleasurable stimuli were not general "distractants" because they elevated pain thresholds but not tactile thresholds differentially, and (c) genital pleasurable stimuli activate an analgesic process that is distinct from a distraction process.     

Patient assertiveness in ethnically diverse older women with breast cancer: Challenging stereotypes of the elderly

Patients' views of patient-physician interactions—particularly the perspectives of older, ethnically diverse women—are poorly understood. The older patient's attitude toward and understanding of the medical encounter, however, are essential to the design of strategies to improve patient-physician communication. To date, investigations have primarily emphasised the ways in which the therapeutic relationship is influenced by immutable patient characteristics. This qualitative study extends previous research findings by looking beyond the effect of ascribed categories (such as age, race, and gender) and focusing on aspects of patient behavior, specifically assertiveness. Focus groups were conducted with older African-, Chinese-, European-, and Hispanic American breast cancer patients from sites in the eastern and western United States. The study explores the potential of a form of patient activation for challenging stereotypes of the elderly and changing health care practitioners' behavior.     

Labour crunch,foreign workers and policy responses: the experience of Japan

"Japan has experienced labour shortages since the late 1960s....The present study is an attempt to analyse the Japanese government's response to circumvent labour shortages. It focuses on two aspects: perception of Japanese society towards the increasing presence of foreign workers in Japan and associated problems; and measures taken by the government to overcome labour crunch. These aspects are examined within the [framework of an] increasing flow of foreigners to Japan during the past decades." (SUMMARY IN FRE AND SPA)