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PubMed2004

Estimating the economic value to societies of the impact of health research: a critical review.

Estimating the economic value to societies of health research is a complex but essential step in establishing and justifying appropriate levels of investment in research. The practical difficulties encountered include: identifying and valuing the relevant research inputs (when many pieces of research may contribute to a clinical advance); accurately ascribing the impact of the research; and appropriately valuing the attributed economic impact. In this review, relevant studies identified from the literature were grouped into four categories on the basis of the methods used to value the benefits of research. The first category consists of studies that value the direct cost savings that could arise from research leading either to new, less-costly treatments or to developments such as vaccines that reduce the number of patients needing treatment. The second category comprises studies that consider the value to the economy of a healthy workforce. According to this "human capital" approach, indirect cost savings arise when better health leads to the avoidance of lost production. The third category includes studies that examine gains to the economy in terms of product development, consequent employment and sales. The studies placed in the fourth category measure the intrinsic value to society of the health gain, by placing a monetary value on a life. The review did not identify any consistency of methodology, but the fourth approach has most promise as a measure of social value. Many of the studies reviewed come from industrialized nations and a proposal is made by the present reviewers for an international initiative, covering developed and developing countries, to undertake further methodological analysis and testing.

Biomedical Research↗
PubMed1991

Regional differences in sodomy laws.

As of 1989, 24 states prohibited either heterosexual or homosexual sodomy. This raises for study the following question: in what ways do states with sodomy laws differ from states without sodomy laws. It was hypothesized that states with sodomy laws are more punitive (as measured by the rate of adults under correctional supervision and the number of restricted civil rights for a felony conviction), rural, and southern. Although the first two hypotheses were rejected, states with sodomy laws scored significantly higher than states without such laws on Gastil's Index of Southerness. Sodomy laws may be more commonly found in the South given regional differences in social values about sex, morality, and family life.

Adult↗
PubMed2001

How to invest in social capital.

Business runs better when people within a company have close ties and trust one another. But the relationships that make organizations work effectively are under assault for several reasons. Building such "social capital" is difficult in volatile times. Disruptive technologies spawn new markets daily, and organizations respond with constantly changing structures. The problem is worsened by the virtuality of many of today's workplaces, with employees working off-site or on their own. What's more, few managers know how to invest in such social capital. The authors describe how managers can help their organizations thrive by making effective investments in social capital. For instance, companies that value social capital demonstrate a commitment to retention as a way of limiting workplace volatility. The authors cite SAS's extensive efforts to signal to employees that it sees them as human beings, not just workers. Managers can build trust by showing trust themselves, as well as by rewarding trust and sending clear signals to employees. They can foster cooperation by giving employees a common sense of purpose through good strategic communication and inspirational leadership. Johnson & Johnson's well-known credo, which says the company's first responsibility is to the people who use its products, has helped the company in time of adversity, as in 1982 when cyanide in Tylenol capsules killed seven people. Other methods of fostering cooperation include rewarding the behavior with cash and establishing rules that get people into the habit of cooperating. Social capital, once a given in organizations, is now rare and endangered. By investing in it, companies will be better positioned to seize the opportunities in today's volatile, virtual business environment.

Commerce↗
PubMed1999

Healthy behaviors, lifestyle, and reasons for quitting smoking among out-of-school youth.

STUDY OBJECTIVE: To investigate the relationships among healthy behavior, healthy values, social influences, and quitting smoking in adolescents not attending school. DESIGN: Following screening procedures, young smokers independently completed a self-report questionnaire administered by trained staff. SETTING: Vocational (TAFE) colleges and Commonwealth Employment Offices (CES) from varying socioeconomic localities were selected as sites to intercept smoking adolescents on their attitudes about quitting smoking. SUBJECTS: Youth attending vocational colleges or CES. RESULTS AND CONCLUSIONS: There were no differences between the two groups of smokers (vocational students and unemployed youth). The decision to quit smoking among these youth is based on a number of factors including social and personal reasons. Health-oriented values were found to be more highly associated with quitting behavior than social influences. Programs for smoking cessation need to be focused on an overall health and improvement approach rather than only a quit-smoking approach.

Adolescent↗
PubMed1998

Spreading disease: a controversy concerning the metaphysics of disease.

This article concerns the metaphysics of disease. Is disease a fixed feature of the world or a social value or preference? I argue that disease is not a value-laden concept and thus debates concerning it differ fundamentally from debates concerning health, harm, or suffering where evaluative judgements are central. I show how the so-called social constructionist view of disease has been motivated both by ethical concerns with medical practices and general theoretical doubts about scientific naturalism. If I can show that ethical concerns about medical treatment can be answered without adopting social constructionism, that leaves only the broader theoretical question of naturalism. I cannot completely answer those theoretical doubts, but I show that the theoretical motivation is less convincing when it is separated from the moral challenge often accompanying it. I conclude that a convincing defense of the non-naturalistic conception of disease is rarely attempted and proves more difficult and counter-intuitive than its proponents assume.

Disease↗
PubMed1976

Evaluation of health care quality by consumers.

Ideological and conceptual issues arising out of the involvement of consumers in health care quality determination are identified. Historically and currently, criteria and procedures for quality review and assessment have reflected the values and interests of the professional providers of health care. This perspective restricts the role of the consumer to that of either a nonparticipant or a data source, at best. If the social values and merits for health care provision of consumer involvement in quality determination are to be realized, then this perspective will need to be modified, and our knowledge base of consumer criteria of health care quality will need to be enlarged. Although the perspectives of probiders and consumers are thought to the antagonistic, they may not, in fact, be so. Some suggested areas of needed research, necessary to policy development and implementation, are offered.

Consumer Behavior↗
PubMed1987

Prenatal screening and discriminatory attitudes about disability.

There is a widespread assumption, with the increased use of reproductive technologies, that prenatal screening reduces the incidence of disability and increases our quality of life. However, because of a growing awareness of the social and political implications of prenatal screening, people have begun to challenge these notions about the quality of life and social value of people with disabilities. This paper presents an overview of the issues surrounding prenatal screening of fetuses with intent to abort on the basis of disability. It raises some of the difficult social, political, and personal questions that women, especially prospective mothers, face regarding these issues, and suggests new perspectives for the decision-making process regarding abortion.

Abortion, Induced↗
PubMedDate not supplied

Standardization of value profiles of dental students and dental faculty.

This study used the Allport-Vernon, Lindzey1,2 Study of Values to establish standardized norms for dental populations, and examined the relationship among freshmen, seniors, and full-time and part-time faculty. The normative data indicate that there is a similarity in general patterns for all groups. The dental student population sampled have higher scores on aesthetic and social values than their counterparts ten years ago.

Faculty, Dental↗
PubMed1985

Learning preferences, values, and student satisfaction.

This study sought to determine the relative importance of values and learning preferences for educational satisfaction and to examine differences in value and learning preferences among undergraduate and graduate occupational therapy students and undergraduate physical therapy students. Although all three groups conformed to a profile of preferring teacher-structured, concrete, interpersonal learning, the graduate occupational therapy students appeared to give greater emphasis to universal social values and to have a stronger preference for abstract learning than both groups of undergraduates. The undergraduates expressed significantly greater satisfaction with their education than the graduate occupational therapy students; for each of the three groups educational satisfaction correlated with a different set of values or learning preferences.

Adult↗
PubMedDate not supplied

Beyond global order.

Patriarchal disciplines dominate in territorial species when they outgrow environmental habitats. This started for mainstream human societies some 6,000 years ago. A few food gatherer-hunter communities still inhabit stable ecosystems. Arts, crafts, languages, creeds and other traditions launched them into cultural diversity. This brought about territorial distinctions. With territorial challenges came uniquely human destruction, conflict and instability. Competitive male-dominated crafts progressively controlled and eliminated species, ecosystems and rival cultures to increase the progeny of dominant males. Technologies, including verbal hierarchies, peculiar to humans, create power pyramids converging in transnational elites. They invade and erode the resources and self-sufficiency of more egalitarian communities, which then strive defensively to join the elites. We need goals and institutions to develop a multiculturally tolerant, intergenerational and ecologically sustainable global co-operative with widening participation and inculcation of social value standards beyond money and male-centred dominance. Some promising techniques are emerging.

Culture↗
PubMedDate not supplied

More evidence of the plateau effect: a social perspective.

The purpose of this study was to test the existence of the plateau effect at the social level. The authors tried to confirm the preliminary conclusion that people may not be willing to trade off any longevity to improve the health state of a large number of people if the health states are mild enough. They tested this assumption using the person-tradeoff technique. They also used a parametric approach and a nonparametric approach to study the relationship between individual and social values. Results show the existence of the plateau effect in the context of resource allocation. Furthermore, with the nonparametric approach, a plateau effect in the middle part of the scale was also observed, suggesting that social preference may not be directly predicted from individual utilities. The authors caution against the possible framing effects that may be present in these kinds of questions.

Activities of Daily Living↗
PubMed1997

Responsibility modelling: a new approach to the process of re-engineering the health-care organisation.

Technology changes our world. It is an accepted fact that the adoption and utilization of information technology by an organization will change the work patterns and power structures of that organization. Health-Care organizations realize that the process of re-alignment and re-engineering is a critical one, as it exposes consumers of health-care to the possible risk of death, or at least the loss of personal information. In this paper I will present the idea of modeling responsibilities as a vehicle for the re-engineering of the processes by which social values are mediated and health-care is delivered.

Computer Simulation↗
PubMedDate not supplied

[Experiences from terminal care. Anthropological principles in human practice].

Paper gives the personal account by physiotherapist working in hospitals and geriatric care centers compelled to give moral assistance to old people engaged in the process of dying without being prepared for it. Moral assistance ad hoc is necessitated by compassion and by patient's struggle to come to terms with an extreme situation. To grasp the real meaning of some main topics of philosophical and theological anthropology is advocated here as a means to prepare assisting person effectively and practically for this task. Topics discussed are: Personal presence of a human being, the human soul, vital activity vs. higher life; experiences of good and evil in one's life time; success and loss in terms of social values; human dignity.

Aged↗
PubMed2001

Building social relationships through valued roles: three older adults and the community membership project.

The experiences of three older adults with developmental disabilities highlight ways in which social relationships can be nourished through the establishment of community roles. Members of the Community Membership Project of the Center on Aging and Community used paid community builders working individually with older persons who had developmental disabilities in order to help them obtain positive, valued social roles and relationships with nondisabled community members. As a means to this end, participants were supported to engage in community activities corresponding to the interests and talents discovered in an initial period of exploration. Stories of these community builders' work illustrate the intentional strategies and concerted effort necessary to create community connections and meaningful relationships.

Community Networks↗
PubMed2003

Retrospection in social dilemmas: how thinking about the past affects future cooperation.

This article reports 2 studies investigating the effects of retrospective thought on future cooperation in social dilemmas. Some general theories of cooperation presume, but have not tested, whether retrospection has impact: People may think about the choices they could have made instead, realize that cooperation would have produced larger outcomes, and change their strategy as a result. Across both studies, the authors show that rate of future cooperation is directly related to the number of best-case scenarios and inversely related to the number of worst-case scenarios generated. The 2nd study also shows that the number and type of retrospective thoughts generated can be predicted from the person's social value orientation.

Adult↗
PubMed1997

Addressing the repressed needs of the Arabic client.

In comparison to families in Western society, the traditional Arabic family plays a relatively greater role in providing support for adult progeny. This serves to condition adult offspring to continue to comply with the will and values of the family. Therefore, in exchange for familial support, Arabic individuals learn to repress authentic needs and emotions, and within that process they relinquish the need for self-actualization. Arabic society discourages individualism and opposes self-actualization by means of simultaneous punishment and moralization. Thus, there is a relatively greater development of the social value system (or superego) and comparatively less development of the self (or ego). In comparison to Western society, Arabic individuals continue to experience greater oppression during adulthood. Given these cultural differences, the processes of reliving and activating repressed needs and emotions, which ultimately serves to promote self-actualization, will transform intrapsychic conflicts into interpersonal and social ones. Thus, personal actions typically encouraged during Western psychotherapy are likely to produce significant social oppression. Indeed, promoting awareness of repressed needs and emotions often leads the Arabic client to become more helpless, because such wishes will rarely be socially sanctioned or satisfactorily fulfilled. Therefore, when addressing repressed needs and emotions in psychotherapy, ego strength, cultural identity, and degree of strictness of the client's family of origin must be considered.

Adolescent↗
PubMed1984

An initial explanatory model of a medical students' preferences for patient types.

Previous studies suggest that medical students and doctors may express a range of positive and negative attitudes and behaviours towards patients. As an initial attempt to understand how attitudes toward patients are formed, first-year medical students were asked to describe their feelings about six categories of patients. These reactions were then correlated with the students' social background, social values and perception of these conditions.

Attitude of Health Personnel↗
PubMed1981

The disabled society?

Benefit payments and numbers of clients on the disability payrolls have substantially increased, while the numbers and proportions of those terminating because of recovery or rehabilitation have steadily decreased. The powerful effects of compensation on the disability process, psychological factors, bureaucratic interests, the weakening work ethic, and changing social values contribute to this problem. The responsibility of medicine with respect to the problem of disability is discussed.

Disability Evaluation↗