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A M Kleinman

Publications and source records attributed to A M Kleinman.

At least 19 recordsLinked to original sources
PubMed1988

Psychopathology and clinical course of schizophrenia: a cross-cultural perspective.

The authors critically review the existing literature on the outcome of schizophrenia in non-Western countries. Compared to studies conducted in Europe and North America, the majority of these non-Western longitudinal followup studies indicated significantly better outcome. Such cross-national variations in the outcome of schizophrenia have been substantiated by two large-scale multicentered studies sponsored by the World Health Organization. Along with this literature review, the authors also discuss potential methodological problems of these studies and examine in detail several key hypotheses concerning mediating factors that could differentially influence the fate of schizophrenic patients in divergent cultural settings. Finally, specific suggestions are made for future research directions.

Cross-Cultural Comparison↗
PubMed1985

An exploration of somatization among Asian refugees and immigrants in primary care.

The clinical records of Chinese, Filipino, Vietnamese, Laotian, and Mien patients in primary care were reviewed to determine the prevalence of somatization, its associated patient characteristics, and the manifested illness behavior. Patients in this study were generally poor, unemployed, and spoke little English. Somatization accounted for 35 per cent of illness visits. These visits were also more costly. Refugees had a higher rate of somatization (42.7 per cent) than immigrants (27.1 per cent). Although sociodemographic characteristics did not strongly differentiate patients with somatization from others, ethnicity and indicators of decreased resources such as large households with low income, households headed by single women, or a limited English proficiency were associated with somatization in certain ethnic groups. Somatization is thus an important health problem among Asian refugees and immigrants.

Adolescent↗
PubMed1983

A direct substitution, equation error technique for solving the thermographic tomography problem.

A new technique for solving the combined state and parameter estimation problem in thermographic tomography is presented. The technique involves the direct substitution of known skin temperatures into the finite difference form of the bio-heat transfer equation as formulated for solving an initial value problem with a convection boundary condition at the skin surface. These equations are then used to solve the inverse bio-heat transfer problem for the unknown subcutaneous tissue temperatures and physiological parameters. For a small number of nodal points, closed form algebraic solutions are obtained. For larger sets of equations, a hybrid technique is used in which the problem is initially posed as an unconstrained optimization problem in which the model equation error is minimized using the conjugate gradient descent technique to get close to a solution. Then a generalized Newton-Raphson technique was used to solve the equations. A numerical simulation of a one-dimensional problem is investigated both with and without noise superimposed on the input (transient) skin temperature data. The results show that the technique gives very accurate results if the skin temperature data contains little noise. It is also shown that if the physical properties of the tissue and the metabolism are known, that a given set of proper transient skin temperature inputs yields a unique solution for the unknown internal temperatures and blood perfusion rates. However, the similar problem with known blood perfusion rates and unknown metabolisms does not yield a unique solution for the internal temperatures and metabolisms.

Biomechanical Phenomena↗
PubMed1982

Sociocultural determinants of the help-seeking behavior of patients with mental illness.

This descriptive study employed semistructured interviewing and questionnaire administration to delineate the sociocultural determinants of the help-seeking process in 48 psychiatric patients. The help-seeking process is considered in two stages. The first stage starts from the recognition of initial symptoms and ends in the first contact with a mental health professional. The second stage is defined as that time between the first contact and actual participation in a planned treatment program. In both stages, patients typically go through phases of lay consultation, nonpsychiatric professional consultation, and referral. The multiple steps which are usually involved in help seeking often result in significant delay of both mental health contact and treatment. The help-seeking process was found to correlate strongly with ethnicity. Both Asians and Blacks showed more extended family involvement, and the involvement of key family members tended to be persistent and intensive in Asians. Ethnicity was also associated with the length of delay, with Asians showing the longest delay and Caucasians the least. These ethnic differences were also reflected in help-seeking pathway assignment using Lin's criteria. Although modernity and parochialism, as measured by the level of modernization and the cohesiveness of the social network system of the subjects, were also found to be correlated with delay, they appeared to exert an influence independent from that of ethnicity.

Adult↗
PubMed1979

Psychiatry's identity crisis: a critical rational remedy.

Psychiatry has several partial identities reflecting its biologic, psychoanalytic, and social subspecialities. It has, however, no encompassing professional identity. This identity requires three features: (a) a common language and procedure for assessing psychopathology, (b) a common method for evaluation and use of knowledge from outside psychiatry, and (c) a common set of values regarding clinical and research activities. The authors discuss the clinical, biologic, and sociocultural psychiatric traditions to identify the roots and consequences of psychiatry's fragmented state. Psychiatry's identity problems cannot be solved by ignoring them or simply becoming more "medical." Rather, the authors propose a remedy--critical rationality--to help resolve the crisis. Critical rationality requires a discimplined approach to psychiatric knowledge that underscores the necessity of methodologic rigor, practicality, and mid-range theorizing (rationality); and the equal necessity for systematic self-criticism, reform, self-awareness, and attention to the ethical dimensions in teaching, practice, and research (critical).

Cultural Characteristics↗
PubMed1975

Immunologic aspects of term pregnancy toxemia. A study of immunoglobins and complement.

IgA, IgG, and IgM were measured by the single radial immunodiffusion method in umbilical cord and maternal sera in toxemia patients and in normal term pregnant cases. Complement (C' 3) levels were determined only in maternal sera. Quantitation of IgA, IgG, and IgM was performed in concentrated serial urine samples from three eclamptic and three normal control patients. Results show that there are lower IgG and IgM levels in the sera of mothers with toxemia of pregnancy; however, paradoxically higher IgM levels were detected in cord sera from their newborn infants without evidence of placental leakage or increased neonatal infection. The finding of the low IgG and IgM levels appears to be due in part to immunoglobin loss into the urine. The unchanged complement levels in toxemia, in this study, are not suggestive of an active immunologic process, but the high IgM in the newborn infants of toxemic mothers is unexplained and may represent active immunologic disease. Clearly, investigations of tissue binding and the formation of immunoglobin complexes should be carried out to better explain these abnormal findings.

Blood Protein Electrophoresis↗
PubMed1975

The symbolic context of Chinese medicine: a comparative approach to the study of traditional medical and psychiatric forms of care in Chinese culture.

This article explores a distinctly different aspect of Chinese medicine, and of health care in Chinese culture, from that receiving most attention and serious study at present in this country. It examines the symbolic structure and significance of illness and care in the Chinese context by (a) applying concepts developed in anthropology and the cross-cultural study of medicine and psychiatry; (b) examining recent studies of folk and popular forms of health care in contemporary Chinese communities; and (c) raising questions about the congnitive structure, cultural background, and bio-social significance of traditional Chinese healing beliefs and practices. An attempt is made to place this analysis in a comparative framework, so that Chinese cases can be related to health care systems in other cultural settings.

China↗
PubMed1975

Dental care.

Explore the source record for details and available documents.

Bloodletting↗