Socialization to dying: social determinants of death acknowledgement and treatment among terminally ill geriatric patients.

Although the vast majority of deaths occur among terminally ill geriatric patients, little is known about the etiology of these patients' death acknowledgement and ultimate type of treatment. Based on interviews with 76 triads composed of physicians, terminally ill patients, and primary caregivers, this study uses the socialization perspective to identify the actors and actions that most strongly affect the patient's death acknowledgment and receipt of exclusively palliative care (i.e., socialization to the dying role). Whereas patient preferences and sociodemographic characteristics do not influence significantly the patient's odds of death acknowledgment, these odds are increased if their primary caregivers accept death, their physicians are not affiliated with a teaching hospital, and the terminal prognosis is disclosed to them and disclosed "matter-of-factly." Patients who acknowledge death, whose agents value pain alleviation over life-prolongation, and whose physicians are not affiliated with a teaching hospital, are substantially more likely to receive exclusively palliative rather than curative terminal treatment.     

Migration research and immigration policy

The author briefly reviews the impact of migration research on U.S. immigration policy over the period 1964-1992. Consideration is given to legal and illegal migrants and refugees.     

Temporary versus permanent population mobility in Melanesia: a case study from Vanuatu

A case study of temporary and circular Melanesian population mobility and labor migration focuses on the island of Paama in the Republic of Vanuatu (an archipelago of 80 islands) in Melanesia and on urbanization, which is a relatively recent phenomena. A critical analysis is provided of temporary and permanent migration and methodological inadequacies in explanations of mobility. Mobility is neither a cause nor a result of economic, social, and political change; it is the interrelationship among the general structural setting, people's personal and social environment, and their perceptions and actions. In the case of Paamese mobility, changes appeared in the source of migration and destination areas. There was a period of original land acquisition, when migrants returning from Queensland with tools were the only ones who could actually acquire land. Inequalities of land access date from this period. The population is dependent on external income sources as well as the need for plantation migration and a huge increase in bridewealth. Concurrently, "kampani" or community work, which ensures the continuous authority of local chiefs and village elders, creates problems for those seeking work for their own families. These conditions encourage out-migration. Rapid urban growth began in the 1960s with a diversified economy. Employment opportunities were available for women; single employee residence spaces declined. This meant families could permanently settle in urban areas. Retirement benefits were also available and contributed to securing permanent migration. There were growing needs for a stable, skilled labor force. Another change was the abolishment of the tripartite colonial administration. Rural disasters and price declines also triggered urban migration. Migration to the town of Port Vila by Paamese men and women between 1953 and 1982 is analyzed, based on 258 employment related mobility histories collected in 1982-83. Two processes are evident: continued periodic, short-term, rural-based circulation and permanent urban migration among Paamese to Port Vila. A major reversal of mobility is unlikely in the future. The reasons why are indicated.     

Wrong lovers in the 19th century Netherlands

Various styles of "male love" occurring in the 19th century are introduced. Locations and public ordinances relating to these styles of love are discussed. The development of the homosexual role is broached along with the question of whether attitudes and laws of the 19th century were responsible in part for the development of normative expectations for homosexuality which might in turn have repressed its growth.     

Realities of life and future prospects within two cultures: unaccompanied minor refugees from South East Asia in the Federal Republic of Germany

From August 1979 on, more than 30,000 refugees from South East Asia were accepted in the Federal Republic of Germany as quota refugees in a special program; among them were 1600 unaccompanied minor refugees. About 1500 were accompanied Vietnamese children and youths who had fled their home country as 'boat people' across the South China Sea. Unaccompanied minor refugees have, like all other recognized refugees, a legal claim to family reunion in the Federal Republic. Today, only parents can join their children and vice versa, and spouses their spouses. The 1st phase of socialization in the lives of the unaccompanied minor refugees evolved in the cultural traditions of their South East Asian country of origin up to the age of 10 to 15 years. In the 2nd phase of socialization--the enculturation--the child establishes its culturally specific emotionality, language, mentality, and patterns of behavior through interaction and verbal communication with the people nearest him. The 3rd phase of socialization begins at school age and reaches full significance at the age of starting to work, with the accompanying expectations of society. Most of the minor unaccompanied refugees from South Asia had already completed their enculturation--the establishment of their cultural identity. The realities of life the young single refugees as foreigners in German society are determined by 4 special factors: 1) the great cultural differences between their country of originin South East Asia and the resettlement country, 2) the young people left their homes as refugees and their resettlement in the Federal Repulic was determined by chance events, 3) they have to live there alone and without the emotional support of their families in a situation of cultural change, and 4) because of their Asian physiognomy they will always appear as foreigners even if they have integrated well. The future prospects of the young South East Asian refugees in German society will be determined primarily by to what extent they will be able to find a satisfactory place within both cultures.     

Child health,breast-feeding,and survival in Malaysia: a random-effects logit approach

This study examines the possibility that estimation of the effect of breast-feeding on infant survival is affected by selection bias, in that children who are healthier at birth may be more likely to be breast-fed. Data are from the 1976 Malaysian Family Life Survey. "Ordinary logit models for breast-feeding and survival are estimated, and the results suggest that selection is indeed present. For example, children of higher birth weight appear to be more likely to be breast-fed and likely to survive. In addition, weight at birth and the duration of breast-feeding appear to be linked." Using birth weight as an indicator for the child's health, the authors conclude that "the direct influence of breast-feeding on survival remains of overwhelming importance even after corrections for selection bias are made."     

Researching in the Victorian censuses: a note on a computerized,annotated bibliography of publications based substantially on the census enumerators' books

The authors describe a project, begun in 1981, to locate, list, and annotate all the published work based substantially on the census enumerators' books for nineteenth-century censuses for England and Wales. The results are currently available in a computerized file, enabling a variety of searches by topic, geographical area, and type of population. Information is provided on using the data and the computerized bibliography. The authors note that, subsequently, data for censuses of Scotland and Ireland have been added.     

American Indian migration and economic opportunities

This article examines interstate migration and labor force participation among White, American Indian, and intermarried Indian/White couples in the US. The results show that endogamous American Indian couples are much less likely to change states of residence than are the other 2 groups of couples. The effect of interstate migration on labor force participation does not vary across the 3 groups of couples. The implications of these results for the assimilation and internal colonial models of race relations and for federal Indian policy are discussed