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PubMed2004

What can decision analysis do for invasive species management?

Decisions about management of invasive species are difficult for all the reasons typically addressed by multiattribute decision analysis: uncertain outcomes, multiple and conflicting objectives, and many interested parties with differing views on both facts and values. This article illustrates how the tools of multiattribute analysis can improve management of invasive species, with an emphasis on making explicit the social values and preferences that must inform invasive species management. Risk assessment protocols developed previously for invasive species management typically suffer from two interacting flaws: (1) separating risk assessment from risk management, thus disrupting essential connections between the social values at stake in invasive species decisions and the scientific knowledge necessary to predict the likely impacts of management actions, and (2) relying on expert judgment about risk framed in qualitative and value-laden terms, inadvertently mixing the expert's judgment about what is likely to happen with personal preferences. Using the values structuring and probability-modeling elements of formal decision analysis can remedy these difficulties and make invasive species management responsive to both good science and public values. The management of feral pigs in Hawaiian ecosystems illustrates the need for such an integrated approach.

Animals↗
PubMed2006

Symbolism of community II: the boundary between community mental health professional and community.

OBJECTIVE: To study the symbolism of community as understood and practised within a mental health Crisis and Assessment Service in an Australian city. THEORETICAL APPROACHES: The paper draws on anthropological theories of symbolism, boundary work and social networks. METHOD: Ethnographic fieldwork techniques were employed for data collection. Ethnographic analysis was then applied to these data. RESULTS: In mental health practice, rules of professional behaviour established a boundary that prohibited mental health professionals from social engagement with members of the community they served. Ethical imperatives prevented them from forming interpersonal bonds with their clients. Rules of privacy and confidentiality meant that they could not relate to the client's social network as a whole. CONCLUSIONS: The companion to this paper identified a summarizing symbol, which we designated community, and it specified the social values it represented when appropriated to the task of drawing a boundary between hospital and community. This paper specifies additional social values represented by community when it is appropriated to the task of drawing a boundary between community mental health professionals and the community.

Community Mental Health Services↗
PubMed2000

New perspectives on vulnerability using emic and etic approaches.

New perspectives on vulnerability using emic and etic approaches The concept of vulnerability has not been developed theoretically from a nursing perspective. It has been viewed epidemiologically as population-based relative risk with little consideration of its experiential qualities. The purpose of this paper is to analyse critically the use of the term vulnerability using elements of concept clarification and a critical literature review. A new perspective of vulnerability is offered based on differentiating between the concepts of risk and experience. Risk consists of assumptions from etic or external evaluation of relative danger while lived experience informs an emic or personal interpretation. Assumptions related to the etic view include normative social values, objective harm and endangerment, and social sanction for intervention. An emic view of vulnerability is based on experiential perception of challenge to personal integrity and the universal and mutual nature of the phenomenon. Questions about the evaluation of harm, potential for growth, subjectivity and objectivity, social sanction and capacity for action, can help clarify the range between these two dimensions.

Anthropology, Cultural↗
PubMed1992

Allocational and distributional aspects of future immigration to Western Europe.

"This article shows that an analysis of the impacts of immigration [in Western Europe] has to be divided into allocational and distributional aspects. From an allocational point of view, like free trade in goods, services and capital, migration is welfare-improving as long as marginal productivities of labor are not equalized worldwide. From a distributional point of view, however, the immigration society has to bear the effects of sharing its common public goods and its social values with the new immigrants. Free immigration will only be allowed if the allocational welfare gains exceed the distributional welfare losses. According to this rule of thumb, a guideline for an efficient migration policy is sketched."

Behavior↗
PubMed2000

Valuing families: social work practice with families from a strengths perspective.

Social work and social workers have long been concerned with families. Historically, most approaches to social work with families have focused on individual pathology and problem solving or have considered problems of a family member to be symptoms of family dysfunction. In contrast, other approaches to social work have focused on growth, function, and healing. This article describes both problem-focused and growth-focused approaches to practice and presents a strengths approach to practice that values families and builds resilience. Assumptions of the strengths approach are discussed and applied to work with families through a case example.

Family↗
PubMed2003

The excluded player in coalition formation.

Coalition research generally assumes that people strive to maximize their share of the coalition payoff and that they exclude others from joining a coalition if these others are not needed to obtain the coalition payoff. In two experiments, the authors show that this view is too narrow and that willingness to include such others is dependent on the extent to which people feel that exclusion affects the payoff of the excluded player. This finding was moderated by social value orientations. Proselfs were not affected by the consequences for the excluded players. Prosocials were less willing to exclude others the more harmful were the consequences of exclusion. Results are related to research on social exclusion, the do-no-harm principle, and social value orientations.

Adult↗
PubMed1993

The trade-off between severity of illness and treatment effect in cost-value analysis of health care.

Social appreciation of health care programs is a function of the severity of the patients' initial state as well as of treatment effect. Prioritising on the basis of cost-per-QALY misses the former point. The trade-off between severity and treatment effect can be expressed in terms of equivalence of numbers for different outcomes. The present study suggests that this trade-off can be modeled mathematically with reasonable accuracy. A table that expresses social equivalence numbers as a function of severity and treatment effect could be used together with guidelines for adjusting for age, duration and risk to estimate the social value of any outcome. In this valuation, saving a young person from dying to a life as healthy (= 1 SAVE) is suggested as the unit of measurement. Cost per SAVE may then be useful as a guiding criterion in prioritising.

Cost-Benefit Analysis↗
PubMed1995

Modeling and eliciting organizational and information system requirements.

Two things have influenced organizational development more than any other: the coffee machine and the computer. The reason for this is that they mediate social relationships. Computers are also being used more and more within every type of organization in an attempt to make the organization faster, more cost efficient, and more competitive. With the adoption of such technology we need to recognize that computers encapsulate social values and can consequently be seen as instruments of power. Within the area of safety critical systems, such as a medical information system, it is vital that, when specifying and capturing requirements about the system, the technical and social values are identified and made explicit. In this paper an outline of a modeling framework will be presented that allows for the encapsulation and analysis of the social and technical aspects of an organizational information system. A modeling language and notation will be constructed and used to construct and analyze both the static and dynamic models of organizations and organizational behavior. The construction and analysis is achieved through the use of concepts such as role and responsibility. The conceptual modeling framework is then applied to a case study. This case study is based upon an accident and emergency department of an inner-city hospital situated within the center of Dublin, Ireland.

Hospital Information Systems↗
PubMed1975

Health services system in Hong Kong: professional stratification in a modernizing society.

A characteristic of modernizing societies is the coexistence of modern and traditional professions that claim to perform the same functions for the society. As a result of differential support by the dominant classes and their social values, and by the academic and the political authorities, the modern profession occupies a higher stratificational ranking than the traditional profession. In order to struggle for survival and to compete for more social-political and economic resources, the traditional profession advocates a rational revival, i.e. a rationalization of its social organization and technical contentmin this paper, I have illustrated these generalized statements by analyzing and comparing the profession of modern medicine with that of Chinese medicine in the modernizing society of Hong Kong, These two types of professional services are coexisting in the pluralistic health context of Hong Kong, but the former enjoys greater power, higher prestige and more economic resources. The state of modern medical dominance may be due to its connection with the dominant social value of science and to its support by the "higher" classes and the university and the government in Hong Kong. In recent years; however, there has emerged a revivalistic movement in the realm of Chinese medical care. In significant part, this may be influenced by developments in the People's Republic of China.

Acupuncture Therapy↗
PubMed2002

Evidence-based medicine as an instrument for rational health policy.

This article tries to present a broad view on the values and ethical issues that are at stake in efforts to rationalize health policy on the basis of economic evaluations (like cost-effectiveness analysis) and randomly controlled clinical trials. Though such a rationalization is generally seen as an objective and 'value free' process, moral values often play a hidden role, not only in the production of 'evidence', but also in the way this evidence is used in policy making. For example, the definition of effectiveness of medical treatment or health care service is heavily dependent on dominant individual or social views about the goals of the particular treatment or service. There is also a concern that a reliance on EBM in health policy will occur at the expense of widely shared social values like equity and solidarity. Moreover, there is a concern that when economic considerations and rational procedures become more influential, various 'outside' groups third parties like insurance companies and policy makers will get a stronger influence on medical practice which may lead to a change in the patient-provider relationship. The authors conclude that social values and patient preference should be explicitly addressed when health policy making is based on economic and other scientific evidence.

Cost-Benefit Analysis↗
PubMed1986

Philosophical origins of the economic valuation of life.

Cost-benefit analysis--applying economic reasoning to increasingly complex health policy decisions--continues to be a source of vehement disagreement among its practitioners. re than merely technical issues in measurement and accounting are involved; basic social values embedded in different intellectual traditions are coming into conflict. The "human capital" and "willingness-to-pay" approaches can each aid policy formulation, but neither can substitute for open political process.

Accounting↗
PubMed2001

The role of information, education and treatment in tobacco control.

Because tobacco use is both an individual and a social behaviour, the efficacy of information, education and treatment addressed to smokers is greatly influenced by the inhibiting or facilitating effects of the environment and the social values given to smoking and to not smoking. The environment is a function of the evolution of tobacco use and the extent of tobacco control efforts. Information is the fuel for legislative and regulatory measures. These and public health education campaigns set the stage for building motivation and confidence to stop smoking and reinforce the social value of non-smoking. As individuals desire, and become prepared for, change, treatments help them address their needs. The role of information, education and treatment are interconnected. Each plays a different and necessary part in building and reinforcing social change and individual behaviour change. They are all needed to move populations and the individuals in those populations as rapidly as possible away from smoking.

Health Education↗
PubMed2006

Self-managing and managing self: practical and moral dilemmas in accounts of living with chronic illness.

BACKGROUND: Patient education self-management programmes draw on sociological understanding of experiencing single chronic illnesses, but health practitioners do not always recognize the tensions and ambiguities permeating individuals' management experiences, particularly for those with multiple morbidity. The aim of this study was to illuminate how people negotiate multiple chronic illness, and everyday life. METHODS: A sample of 23 people in their early 50s was recruited from a community health survey in Scotland. The participants had four or more chronic illnesses and were interviewed twice. The qualitative data that were generated highlighted the impact of illness and associated management strategies, as people attempted to continue familiar lives. Analysis was based on constant comparison and informed by a narrative approach. RESULTS: People used multiple techniques to manage symptoms and conveyed a moral obligation to manage 'well'. However, maintaining valued social roles, coherent identities and a 'normal life' were prioritized, sometimes over symptom containment. This led to tensions, and participants faced moral dilemmas as they self-managed. DISCUSSION: Self-management policies, programmes and healthcare practitioners need to recognize the tensions that people experience as they negotiate symptoms, valued social roles, positive identities, and daily life. Addressing these issues may improve opportunities to support patients in particular contexts, and enhance self-management.

Adaptation, Psychological↗
PubMed1995

Physicians' intention to stay in or leave primary care specialties and variables associated with such intention.

A national mail survey of primary care physicians was conducted in 1993 to examine the differences between those who planned to leave and those who planned to stay in primary care disciplines. The physicians who planned to stay in primary care were those who, at the time of choosing primary care specialties, were more influenced by factors such as personal social values, religion, and the presence of a role model prior to medical school. Physicians' race, sex, workload, debt, place where they grew up, family income as a child, and timing when they made the decision to enter primary care disciplines are not associated with their plans to stay in or leave primary care disciplines. Findings indicated that personal social values, religious beliefs, and the presence of a role model prior to medical school not only influenced physicians' choice of primary care, but had a lasting effect on their commitment to such choice.

Career Mobility↗
PubMed2004

Antioxidant enzyme and malondialdehyde values in social phobia before and after citalopram treatment.

A growing body of evidence indicates that oxidative stress is involved in the etiopathogenesis of some psychiatric disorders. In our previous study, we have found that social phobia (SP) seems to be associated with elevated antioxidant enzymes and malondialdehyde (MDA) levels, a lipid peroxidation product. In the present investigation, we sought to determine whether the increased radical burden observed in patients with SP would be attenuated with alleviation of symptoms. Thirty-nine patients diagnosed with generalized SP and 39 healthy controls participated in this study. The measurements of MDA, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) were performed before and after a period of 8 weeks of citalopram treatment. In this period, the patients received citalopram but controls did not. The initial dose of citalopram was 20mg, with 20 mg increments occurring every 2 weeks, to a maximum dose of 60 mg, with the mean daily dose of 38.9 +/- 13.3 mg/day. All patients were evaluated by using Liebowitz Social Anxiety Scale (LSAS). The mean MDA, SOD, GSH-Px and CAT levels of the patient group at baseline were significantly higher than those of controls. Antioxidant enzymes and MDA levels decrease significantly through citalopram treatment. Significant and positive correlation was observed between decrease in the total LSAS scores, and SOD or CAT levels. In conclusion, our results suggest that, in patients with SP, subchronic treatment with citalopram may decrease antioxidant enzymes and MDA values and that they are state markers of SP because they return to normal values with treatment.

Antidepressive Agents, Second-Generation↗
PubMedDate not supplied

Social roles in women's lives: changing conceptions of self.

As part of an effort to improve services and outcomes for women with histories of trauma and co-occurring mental health and substance abuse disorders, the Franklin County Women and Violence Project sought to assess women's perceptions about their social roles and provide them with opportunities to adopt valued social roles. Social role theory suggests that individuals with devalued roles may benefit through the acquisition of valued roles. This article outlines the findings regarding the women's initial assessments of their social roles as well as real and desired changes 3 months after the baseline interview. Findings suggest that valued social roles play a significant role in helping women heal and recover, contributing to greater self-esteem, confidence, and happiness. Conversely, the adoption of devalued roles or worsening of roles contributes to depression and makes it more difficult for women to heal and recover.

Adult↗