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PubMed1999

Excess capacity: markets regulation, and values.

OBJECTIVE: To examine the conceptual bases for the conflicting views of excess capacity in healthcare markets and their application in the context of today's turbulent environment. STUDY SETTING: The policy and research literature of the past three decades. STUDY DESIGN: The theoretical perspectives of alternative economic schools of thought are used to support different policy positions with regard to excess capacity. Changes in these policy positions over time are linked to changes in the economic and political environment of the period. The social values implied by this history are articulated. DATA COLLECTION: Standard library search procedures are used to identify relevant literature. PRINCIPAL FINDINGS: Alternative policy views of excess capacity in healthcare markets rely on differing theoretical foundations. Changes in the context in which policy decisions are made over time affect the dominant theoretical framework and, therefore, the dominant policy view of excess capacity. CONCLUSIONS: In the 1990s, multiple perspectives of optimal capacity still exist. However, our evolving history suggests a set of persistent values that should guide future policy in this area.

Attitude to Health↗
PubMed1979

Control, participation, and the British National Health Service.

The experience of Britain's National Health Service since 1948 suggests that there is a conflict between different social values and policy aims, and that progress toward achieving more community or worker control is constrained by the pursuit of other desired objectives. The egalitarian ideology of the NHS emphasizes central control to achieve a nationally equitable distribution of resources. Emphasis on coordination between the NHS and other social services limits freedom of action. Democracy as accountable policy-making on a national scale may therefore be incompatible with democracy as direct control, whether by community or workers. To encourage participation means accepting diversity in the provision of health care and the multiplication of small, self-governing units. Similarly, worker control is professional autonomy writ large and may therefore conflict with community control.

Community Health Services↗
PubMed1978

Rehabilitation experiences of women ex-addicts in methadone treatment.

In-depth interviews were conducted with 16 female "hard-core" heroin addicts on a methadone maintenance treatment program 1 year or longer to learn what the rehabilitation process is like for women and how their life-styles had changed since being in treatment. The paper describes the adjustments and special difficulties experienced by women through patients' own accounts. Behavioral changes were verified by clinic records and staff. Cessation of criminal behaviors, regulation of daily living patterns on methadone, increased social productivity, and adoption of new social values were noted. Persisting problems include loneliness, motivational difficulties, and an incomplete transition to ordinary society.

Adult↗
PubMed2000

When the smile is a cue to familiarity.

The question discussed in the two following experiments concerns the effect of facial expressions on face recognition. Famous and unknown faces with neutral or smiling expression were presented for different inspection durations (15 ms vs 1000 ms). Subjects had to categorize these faces as famous or unknown (Experiment 1), or estimate their degree of familiarity on a rating scale (Experiment 2). Results showed that the smile increased ratings of familiarity for unfamiliar faces (Experiments 1 and 2) and for famous faces (Experiment 2). These data are discussed in the framework of current face-recognition models and are interpreted in terms of social value of the smile. It is proposed that the smiling bias found here acts at the level of the decision process.

Cues↗
PubMed1986

Attitude and personality correlates of hallucinogenic drug use.

Personality, attitude, and hallucinogenic drug use data were obtained from 298 male and female adult members of labor unions. Multiple regression and canonical correlation analyses of drug use, personality, and attitude data revealed that: the use of hallucinogens was significantly related to needs for novel or unconventional experiences and negative attitudes toward conventionally defined social values, and marijuana use scores were more strongly associated with the set of predictor variables than were other drugs reported.

Adolescent↗
PubMed2004

Information empowers but who is empowered?

This article presents part of the findings of a study that examined an information pamphlet written by nurses and given to relatives of patients in a Critical Care Unit (CCU) in an Australian acute care hospital. The pamphlet, Information for Relatives, was analyzed using Systemic Functional Linguistics (SFL) and examines how a relatives' information pamphlet written by nurses constructs the reader-relatives' view of a Critical Care Unit. The results revealed how the language chosen by the nurse-writers of this pamphlet acts to restrict and constrain the reader-relatives while constructing the staff as ethical experts. Furthermore, it questions the notion that all information empowers healthcare clients and demonstrates how this information pamphlet is not value free but has embedded in it social values of the culture from which it emanates. The pamphlet empowers the writers and staff, not the relatives.

Australia↗
PubMed1995

The hidden science of eugenics.

The early eugenicists were not stupid, but they did not share our social values. The rise and fall of the eugenics movement is a history that modern medical geneticists would do well to heed.

Animals↗
PubMed2001

Correlates of psychotropic drug use in the elderly compared to adults aged 18-64: results from the Quebec Health Survey.

This study documents correlates of psychotropic drug use among older adults and compares the results observed in this group to those observed in individuals aged 18-64. A multivariate logistic regression analysis using data from the Quebec Health Survey (1992-1993) was employed to study predisposing and facilitating factors of this behavior. Results showed that 22% of the elderly reported having used anxiolytics, sedatives or hypnotics during the two days preceding the survey, compared to 4.9% of the respondents aged 18-64. Combining both samples, perceived health status, physical functional status, and health services utilization for psychological distress symptoms were the main health factors associated with psychotropic drug use. A significant difference was observed between the two age groups with regard to the association between the respondents' health status and the use of anxiolytics, sedatives or hypnotics. When the effect of other explanatory factors was controlled, older adults in poor health used anxiolytics, sedatives or hypnotics 2.21 times more than individuals aged 18-64 with a similar health condition, whereas older adults in good health used these drugs 7.49 times more than healthy individuals aged 18-64. Furthermore, after controlling for the effect of the respondents' physical and psychological health status, our results showed that more women than men used psychotropic drugs (OR = 1.57; 99% CI = 1.26-1.94). Low-income respondents were also more likely to report using these medications (OR = 1.53; 99% CI = 1.22-1.90). These results were interpreted as supporting the socio-cultural hypothesis of psychotropic drug use, which suggests that the prescribing and utilization of psychotropic drugs is influenced not only by symptoms but also by the social characteristics of individuals. It is suggested that future research may contribute to a better understanding of psychotropic drug utilization in the older adult community-dwelling population by examining consumers' attitudes and health care providers' social values concerning the appropriateness of this behavior.

Adolescent↗
PubMed2000

Moral reasoning, interpersonal skills, and cognition of rapists, child molesters, and incest offenders.

54 inmates were subdivided into four groups and classified according to their index offense. The groups included Rapists (n = 14), Incest Offenders (n = 9), Child Molesters (n = 11), General Offenders (n = 20). Nonoffenders (n = 20) were included as a control group. Psychometric tests including the Test of Nonverbal Intelligence, the Defining Issues Test, Survey of Interpersonal Values, Porteus Maze, and Minnesota Multiphasic Personality Inventory were administered to all inmate and control groups. Analysis showed the rapists and child molesters scored higher on moral reasoning on the Defining Issues Test; also rapists' scores were more elevated on the Psychopathic Deviate and Paranoia scales of the Minnesota Multiphasic Personality Inventory than those of other offender and control groups. These results imply that rapists and child molesters have the ability to understand moral issues; however, given their personality orientation, they ignore these interpersonal social values.

Adolescent↗
PubMed2006

Material civilization: things and society.

This paper argues that although classical sociology has largely overlooked the importance of social relations with the material world in shaping the form of society, Braudel's concept of 'material civilization' is a useful way to begin to understand the sociological significance of this relationship. The limitations of Braudel's historical and general concept can be partially overcome with Elias's analysis of the connection between 'technization' and 'civilization' that allows for both a civilizing and a de-civilizing impact of emergent forms of material relation that both lengthen and shorten the chains of interdependence between the members of a society. It is suggested that the concept of the 'morality of things' employed by a number of commentators is useful in summarizing the civilizing effects of material objects and addressing their sociological significance. From the sociology of consumption the idea of materiality as a sign of social relationships can be drawn, and from the sociology of technology the idea of socio-technical systems and actor-networks can contribute to the understanding of material civilization. It is argued that the concept of 'material capital' can usefully summarize the variable social value of objects but to understand the complexity of material civilization as it unfolds in everyday life, an analysis of 'material interaction' is needed. Finally the paper suggests some initial themes and issues apparent in contemporary society that the sociological study of material civilization might address; the increased volume, functional complexity and material specificity of objects and the increased social complexity, autonomy and substitutability that is entailed. A theory of 'material civilization' is the first step in establishing a sociology of objects.

Capitalism↗
PubMedDate not supplied

Pharmacopolitics and deliberative democracy.

Setting priorities in healthcare has become a highly politicised activity. Traditionally it has been undertaken by government and the health professions but there is an increasing imperative to involve the public. The National Institute for Health and Clinical Excellence (NICE) has established a Citizens' Council as an attempt to capture the informed views of the public in shaping the Institute's social value judgements. Although, in the future, better ways of involving the public may emerge, NICE's approach represents one way in which ordinary citizens can engage in the process of prioritising healthcare.

Community Participation↗
PubMedDate not supplied

The prestige of dermatologists. Are they "last among equals"?

Dermatology generally has been rated low in past studies of the prestige of medical specialties when the raters have been doctors and/or medical students. This investigation considers whether dermatologists maintain their relatively unfavorable position in the specialty prestige hierarchy when the raters are members of the lay public. Four hundred respondents ranked dermatology last out of ten specialties in ascribed esteem, perceived income, and assigned social value, suggesting that dermatologists are less well regarded by the public than are other doctors. Moreover, the relatively low prestige of dermatology appears to be largely independent of a rater's personal experience.

Dermatology↗
PubMed1997

Body image change in pregnancy: a comparison of normal weight and overweight primigravidas.

BACKGROUND: Body image in pregnancy has been linked to maternal and neonatal health. This study examined the relationship between prepregnancy body weight and body image change in primigravid women. METHODS: Through a self-administered, free-response questionnaire, 76 primigravidas of at least 30 weeks' gestation described their feelings about current appearance and body shape and compared these to prepregnancy feelings. Respondents also completed the Body Shape Questionnaire to measure current concern with body shape. RESULTS: Women who were overweight before pregnancy were more likely to have had a positive change in body image when they were at more than 30 weeks' gestation. Women who were normal weight before pregnancy were more likely to have had a negative change. Despite overweight women's positive changes, their body shape concerns were more negative than those of normal weight women. CONCLUSIONS: Our study highlights the relationship between social values, prepregnancy body weight, and body image change during pregnancy. Some women may benefit from discussing their experiences in a patient-centered context.

Adult↗
PubMedDate not supplied

Attitudes and values of Peruvian coca growers.

This study uses semi-structured interviews to examine the attitudes and values of Peruvian coca growers toward coca leaf and cocaine basic paste (CBP) consumption and its distribution. The subjects of the study were 186 coca growers from Peruvian jungle valleys who are involved in illegal commercialization of coca leaf and cocaine paste production. Data collected in 1994 reveal that growers consider coca leaf to be a most profitable product and a unique opportunity to improve their quality of life. Although growers acknowledge that a problem exists among local users, they do not assume any responsibility for CBP consumption and dissemination in rural areas. This leads to the conclusion that awareness of a CBP consumption problem is not enough for growers to stop drug production; they need consistent training in social values, as well as support in legal and economic alternatives.

Adult↗
PubMed1994

Marriage and cohabitation in a changing society: experience of Norwegian men and women born in 1945 and 1960.

"Retrospective survey data are used to estimate the effect of various factors on the transitions to first marriage or first cohabitation among single Norwegian men and women born in 1945 and 1960. A high educational level is not found to reduce marriage intensities for women, although educational enrollment appears to be less compatible with marriage for women than men. The effect of employment varies according to prevailing sex-role expectations. The data support the assumption that modern cohabitation developed from two socially opposite origins, the educated elite and the working class. A social value dimension is assumed to have a major effect upon the present-day choice between marriage and cohabitation." (SUMMARY IN FRE)

Behavior↗
PubMed1997

The utility of DALYs for public health policy and research: a reply.

The WHO Advisory Committee on Health Research (ACHR), through its DALY Review Group, has recently criticized the use of disability-adjusted life years (DALYs). To suggest that the use of DALYs should be discouraged as an aid in health resource allocation may, however, be premature, since it enhances informed debate on the social values that influence resource allocation, identifies health problems that may be neglected, and points to the strengths and weaknesses of existing health information systems.

Persons with Disabilities↗
PubMedDate not supplied

What price parenthood?

Current reproductive technology challenges us to think seriously about social values surrounding childbearing. Thoughtful discussion must combine careful attention to the experience of pursuing parenthood by technological means with principled reflection on the morality of this pursuit.

Dehumanization↗