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.     

Identity and Boundary Tensions When Educators and Mental Health Professionals Collaborate: Between Wish and Reality

Schools are centers of collaboration in promoting the development and learning of children and adolescents. They seek to develop cultures of collaboration not only within their walls but also among constituencies with similar interests. These efforts, unfortunately, all too often prove frustrating and disappointing to all concerned. Yet, the need for interdisciplinary inquiry is greater today than ever before. This is particularly true considering the complex, diverse, and multifaceted nature of today's schools. No one professional can address all of the problems confronting education, particularly those of urban schools. For decades mental health and education professionals have joined together around their similar interest in promoting children and adolescent development. One such initiative is a program that fosters educators' development. This program, named the Teacher Education Program, began under the auspices of the Chicago Institute for Psychoanalysis and evolved into the Human Development and Learning Program when a partnership was formed with DePaul University's School of Education. From the program's 34-year history, the authors highlight specific tensions they experienced as directors of this collaborative initiative, and how these challenges either were or were not anticipated and/or addressed. The aims are to put a human face on the challenges and struggles encountered in the relationship between education and mental health professionals, and to identify common ground between educational and psychoanalytic theories and practices.     

Comparing developmental outcomes for children in care with those for other children in Canada

This study assessed the test–retest reliability and convergent validity of single items from the Assessment and Action Record (AAR), from Looking After Children (Ward, 1995). It also compared developmental outcomes of 43 children cared for by a Canadian child welfare agency and those of an approximate comparison group of 1,600 children from the National Longitudinal Survey of Children and Youth (Statistics Canada, 1995). High and low reliability and validity were found for different AAR items. The children in care had worse outcomes than the comparison children on indicators of educational success and negative behaviour, but not on measures of identity, social and family relationships, or prosocial behaviour.     

Exploration to Foster Career Development

Responses to the Adult Career Concerns Inventory (ACCI: Super, Thompson, Lindeman, Myers, & Jordaan, 1988) were organized through cluster analysis to identify different ways in which adults use exploratory behavior to cope with career development tasks. Significant differences in life-role salience among the types of adult career explorers identified were also investigated. Findings indicated a variety of ways in which adults use exploratory behavior. However, no significant differences were found in life-role salience among the types of career explorers. The discussion explains how career counselors can interpret their clients' ACCI profiles to select appropriate career interventions.     

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.     

The Future of Environmental Justice Research: A Response to Gould and Weinberg

Sociological Forum -     

Implications of ERISA for health benefits and the number of self-funded ERISA plans

This Issue Brief provides an overview of the issues relating to the Employee Retirement Income Security Act of 1974 (ERISA) and health benefit plans, the major case law relating to ERISA and health plans, and the implications of the preemption of state regulations for health plan sponsors and participants. It also presents the latest data on the number of health plan participants in self-funded ERISA plans. Finally, it presents a summary of current legislative proposals that would attempt to amend ERISA. Under the framework ERISA established for employee benefit plans, the regulation of employment-based health benefit plans has evolved into a two-tiered system in which both federal and state laws play important roles. The Supreme Court has interpreted ERISA's "savings" and "deemer" clauses to mean that insured plans are subject to regulations directly at the federal level and indirectly at the state level, while self-funded plans are regulated exclusively at the federal level. The ERISA statute and the courts' interpretations of the Act have created a sharp controversy over how employee health benefit plans are provided and administered, with state regulators and consumer advocates on one side of the debate and plan sponsors (e.g., employers and unions) on the other. State regulators and consumer advocates tend to favor more regulation, and in many instances greater regulation at the state level, which they argue would provide more protections for consumers. However, employers and unions (or any plan sponsors) think ERISA preemption is very important to their ability to provide innovative and cost-effective health benefits for their employees, and assert that ERISA's present structure should be preserved. The U.S. General Accounting Office (GAO) found that 44 million individuals (39 percent of those in ERISA plans) were enrolled in self-funded ERISA plans in 1993, up from 39 million (33 percent of those in ERISA plans) in 1989. The Employee Benefit Research Institute (EBRI), using the same methodology as GAO with 1995 data, estimated that 48 million individuals (39 percent of those in ERISA plans) were enrolled in self-funded ERISA plans in 1995. When policymakers look to amend ERISA, they should consider whether the change to ERISA will produce a higher level of quality for consumers than is being provided under the present system and will continue to do so in the future. Policymakers must also decide whether quality of care is better enhanced by health plans' greater exposure to liability or by market forces. If policymakers decide that increased exposure to liability is the route to go, will consumers be able to enjoy any potential improvement in quality or will more individuals end up uninsured because of increased costs and not be able to get any care regardless of the quality?