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The maintenance of behavior change as an indicator of social validity.

This article reviews research pertaining to use of social validity and presents a rationale for expanding the conceptualization and use of this construct. It is proposed that the degree to which obtained treatment gains maintain across time within natural contexts be considered as a primary indicator of social validity. Traditional forms of social validation--subjective evaluation and normative comparison--are presented as measures that, when used within the framework of maintaining behavior change, form an iterative and heuristic process in which behavior change goals, procedures, and outcomes are altered to increase and/or sustain their social value. Procedural guidelines for research using maintenance as the benchmark of social validity are discussed.

Behavior Therapy↗

Predictions of rodent carcinogenicity testing results: interpretation in light of the Lave-Omenn value-of-information model.

The recent National Institute of Environmental Health Sciences/National Toxicology Program Carcinogen Prediction Challenge elicited a valuable array of predictions of the carcinogenicity of chemicals tested in the lifetime rodent bioassay. The data warrant additional analyses of the similarities and differences of the predictive methods. We provide here analyses of the sensitivity, specificity, and false-positive/false-negative tendencies of the different sets of predictions. Our value-of-information model provides guidance to testing agencies and regulatory agencies in determining the social value of additional information and setting up the framework for assessing the social consequences of different test strategies and nontest predictive methods. These considerations deserve attention in the second round of the Carcinogen Prediction Challenge.

Animals↗

A historical perspective on professional values.

This article demonstrates the use of historical research to improve present allied health practice. The relationship between social values and the emergence of occupational therapy during the progressive era (1890-1920) is explored. This energetic period of history provided an opportunity for physicians to assume social, moral, and scientific leadership in a society that longed for expert solutions to complex social problems. At the turn of the century, occupational therapy, physical therapy, medical social work, and speech therapy all expanded the influence of the physician's expertise. Occupational therapy was originally developed to care for chronically impaired individuals. The relationship established between the physician and the therapist over 75 years ago still influences the status of both professions today.

Art Therapy↗

[Influence of individual cultural life on the penal system: the role of the medical expert].

A French Melanesian citizen who killed his uncle attributed his act to local beliefs involving witchcraft. The medical expert called on to give his psychiatric assessment ponders if he was able to fulfill his role of mediator. Since examination of the defendant revealed no mental abnormalities, the only possible explanation for the crime was the one implicating the local culture that made the defendant say that he had not killed a relative but rather a sorcerer. The psychiatrist asked the lawyer for a complete legal opinion. From the penal standpoint establishing responsibility depends on the defendant's powers of discrimination. Criminal law distinguishes between the intent, motive, and objectives of an act on the basis of one criteria which is damage in most cases. In the present case the act was intentional, the motive could not be taken into account, and the objective could not be considered to have social value. This case forces the conclusion that the juridical concept of "justifying fact" is based on social choices that rarely coincide with the culture of individuals in a minority group. By finding the defendant guilty the judicial system achieved social redress with respect to one culture but denied moral redress according to the values of another.

Cultural Characteristics↗

Ex post value reimbursement for pharmaceuticals.

The paper examines the welfare properties of an ex post value regulation scheme in which a pharmaceutical firm's revenue varies with the social value of its product. The mechanism, which is a variant of that proposed by Loeb and Magat, leads to efficient investment in research and development (R&D), production, consumption, and promotion under certain market and technologic conditions. The mechanism's attractive simplicity is lost when account is taken of the rivalrous nature of R&D, the fact that drugs can be complements or substitutes, the excess cost of taxes needed to finance the mechanism, and the multinational character of most pharmaceutical firms.

Drug Industry↗

Social desirability bias in diary panels is evident in panelists' behavioral frequency.

The purpose was to analyze a large-scale database, a national sample of 1108 heads of households collected by AT&T, to show that behavioral frequencies of the activities of consumer diary panelists may regress toward the population mean during the diary-keeping period given social desirability bias produced by the conditioning effect of keeping diaries. This effect is distinguished from regression toward the mean, a statistical phenomenon reflecting happenstance of extreme initial values. Social desirability bias is demonstrated in two ways-by observing decreasing coefficients of variation over time and by detecting a greater proportion of panelists' behavioral frequencies moving toward the population mean than moving away from it. Both cannot be explained by regression toward the mean. Social desirability bias was manifest only during the early stages of the diary-keeping period and only for activities high in involvement. The presence of social desirability bias in diary panels implies that, when people are subjected to observation, diary observations may be contaminated, leading to the mistaken impression that the population is more homogeneous than it actually is. Thus it is important for researchers to monitor the diary panel carefully to detect social desirability bias when engaged in longitudinal studies.

Bias↗

Diminishing returns? The costs and benefits of improving health.

In this paper, we develop and apply an economic framework for valuing improvements in health, based on Murphy and Topel (2002). Past improvements in health and longevity have had enormous social value. By our estimation, the contributions to the economic well-being of longer lifetimes have been worth about dollar 73 trillion since 1970, or about dollar 2.6 trillion per year. The average 50-year-old man gained additional life-years worth roughly dollar 350,000, while a 50-year-old woman gained about dollar 180,000. Looking ahead, prospective benefits from further progress are also large: a 10 percent reduction in mortality from heart disease would be worth over dollar 4 trillion, and even a 1 percent reduction in cancer deaths would be worth over dollar 400 billion. These values suggest that public investments in basic medical research may yield huge social returns, but distortions in the allocation of medical care and in research incentives may yield future benefits that are smaller than the costs of achieving them. While the average net health benefits of increased medical expenditures are large, costs may have greatly exceeded benefits in certain periods and age groups.

Aged↗

[Sexuality, psychiatric institution and normalization of the mentally ill.].

The author sets three objectives: to determine the status of sexuality in pedagogical institutions; to examine the means used to control sexuality; and to trace a global interpretation of the links between sexuality and the institution. The development of the asylum saw the appearance of moral treatment which sought to promote certain social values and to repress those behaviours such as sexual activity which opposed the fundamental bourgeois social virtues. These notions were presented in the guise of an ethical standard and a normative scientific current (eg. sexuality is a symptom to be eliminated; it is a cause of insanity.) Now, while no longer attacked in the institution, sexuality is nonetheless perceived as lacking any inherent value and is worthwhile only in terms of its therapeutic utility* The same phenomenon is observable in the school. To illustrate the second point the author analyses the phenomenon of masturbation. The 18th century saw masturbation cited as the cause of insanity and numerous physical disorders. Viewed as a diversion of the child's natural forms, and as bringing into question the substitutive educational system, masturbation was excluded from the school of the period. At present, masturbation is permitted but there is no recognition of the child's free enjoyment. Instead a system of exercises has been developped which permit the child greater body control. This masturbation has become a therapeutic technique to obtain a normative level of pleasure.Touching on the third point, the author states that society regulates sexual life with a complex normative system in order to incorporate it within an identification with sexual institutions and no longer with judicial sanctions. Applying this analysis to the situation of the mentally ill, the author argues that the latter's sexuality is socially normalized by the definition and utilisation of illegal areas where it's actualization is permitted.

English Abstract↗

Social-network considerations in the alcohol field.

This chapter reviews the literature on social networks in the alcohol field. The review focuses on the dynamics of the social-network system and network analysis. Stressors to recently urbanized persons are also examined in a discussion of social adaptation, social identity, and networks. The findings of several studies that are summarized indicate that there is a crisis in changing cultural styles and social values that develops after migration and resettlement. An aspect of this review suggests that social networks may be utilized as stress-buffering strategies in both a constructive and a destructive fashion during these periods of crisis. The author describes these networks as pathways to care and illustrates how they might play a significant role in alcoholism-treatment and recovery programs. Finally, the author concludes with some possible directions for future research on the systematic study of social bonds.

Alcohol Drinking↗

Old age in Nepal: some preliminary observations.

Problems of old age in Nepal are examined using census data and field reports. The paper is organized in three parts. "The first part gives a demographic sketch [of the aged in Nepal]...along with a short discussion of the economy....Next, a brief account of...cultural and social values is given. Finally, the question of old age is reviewed in light of social changes taking place in Nepal's urban centres, and their implications for policy and planning."

Adult↗

Identity and name changes.

The theoretical literature as well as case material presented point to the intimate relationship of name changes to identity struggles. Names have strong affective value and symbolize an important part of a person's identity. The cultural and social value of a name may be secondary to the personal meaning of that name to the individual who in changing it will reveal an inner change in his sense of identity or an inability to integrate a diffuse sense of identity. The answer to "what's in a name?" may be "Identity's in a name."

Culture↗

Evaluating summer camps 1979 - problems of measuring behaviour change in children.

To develop experience in assessing behaviour change in children, sixteen children attending week-long summer camps run by the Department of Psychiatry, Adelaide Children's Hospital in January 1979, were assessed every two months for six months. Target complaints, symptom checklists and measures of social behaviour were chosen as being most likely to be sensitive to behaviour change. Hypotheses about the summer camp experience having an influence on severity of target behaviour problems, symptoms indicating child psychiatric disorder, peer group participation, mastery of aggression and development of conscience and social values were not convincingly supported. Agreement between camp staff and parents rating the children's social behaviour using the same instrument a week apart was poor. Simple ranked adjective scales have advantages over goal attainment scaling for rating target complaints, Implications for treatment evaluation in child psychiatry are discussed.

Adolescent↗

What has bioethics to offer the developing countries.

My paper consists of three parts. In the first part I try to explain the intellectual basis of bioethics in developing countries. In the second part I describe the bioethical dilemmas facing these countries. In the third part I shall discuss the changes that have to be made in bioethics if it is to take root in these countries, and thereby help them to improve the human existence.

Bioethical Issues↗

Between education and memory: health and childhood in English-Canada, 1900-1950.

Despite contemporary concerns regarding the state of Canadian children's health, historians in Canada have yet to fully explore how conventional medical experts and educators thought about, and safeguarded, children's health. This paper explores the interplay between two sources of information regarding the provision of healthy children between 1900 and the end of the Second World War in the English Canadian context: curricular messages regarding health and illness aimed at public school children and the oral histories and autobiographies of adults who grew up in this period. Rather than simply juxtapose official health curriculum and lived memory, I argue that the two co-mingled to produce differing kinds of embodied knowledge aimed at the production and reproduction of hegemonic social values in the English Canadian setting. These values co-existed both harmoniously and uncomfortably, depending very much upon the priorities of, and socially constructed limitations placed upon, particular families in particular contexts.

Canada↗

Differential reinforcement of other-than-vocalization as a control procedure in the conditioning of infant vocalization rate.

The purpose of the present study is to demonstrate reinforcement control over infant vocalization rates using a DRO schedule to control for elicitation of social stimulation. Mothers of four 2 1/2- to 3-month-old infants provided social reinforcement for their infants' vocalization under two schedules: continuous reinforcement (CRF) and differential reinforcement of other-than-vocalization (DRO). In a repeated-reversal single-subject experimental design, all four infants produced systematically higher vocalization rates during CRF, even though densities of social stimulation during DRO were equal to or greater than densities provided during CRF. Thus, whatever its elicitation value, social stimulation may reinforce infant vocalization rates.

Conditioning, Operant↗

[Characteristics of addictions in Bosnia and Herzegovina a review of prevention programs].

Hazardous and harmful use of alcohol and drugs, accompany human race for centuries, and represents transcultural phenomena as well as one of the problems that still does not have solution. According to consequences that it's causing to individual, family and community it is one of the most severe social problems. Although, international community is investing more and more efforts and money to prevent illicit drug traffic, reduce consumption of alcohol and improve prevention, treatment and rehabilitation of addicts, still some significant results are not reached. War in Bosnia and Herzegovina cause severe injuries to population and left devastation and misery. War crimes are reflected in 200,000 deaths, several thousand wounded and over one million traumatized. Transition societies, as our, are characterized with big social changes such as migrations, urbanization and destruction of traditional social values. Due to this extensive drinking and drug use, as a form of escape from the reality and social difficulties are characteristic of our society and current civilization. It is estimated that currently in B&H exist 10,000 opioid addicts, and 20,000 alcoholics. Rapid incensement in number of addicts, and problems caused by that was the reason why we after the war started with preparations of Preventive Programme with focus on primary prevention. Beside programs that was made on the local levels, during 2002 Federal Programme of prevention was accepted which anticipated activities at all three preventive levels.

Bosnia and Herzegovina↗

Early rehabilitative treatment in patients with traumatic brain injuries: outcome at one-year follow-up.

AIM: The aim of this study was to analyze the outcome at one-year follow-up of patients with traumatic brain injuries (TBI) after 4 years of application of our organizing model and compare our results with the international data in terms of disability (functional independence measure [FIM], disability rating scale [DRS] scores) and social integration (community integration questionnaire [CIQ], work reentry) METHODS: We started a routine based on the presence of the physiatrist in the Intensive Care Unit (ICU) and Neurosurgery 3 times per week to evaluate all patients with TBI, program and control physiotherapeutic treatments and transfers to rehabilitative centers. Data were collected considering 80 TBI patients sequentially discharged from our department, from August 1999 to December 2003. The sample was composed of patients with severe brain injury evaluated at rehabilitation admission, rehabilitation discharge and one-year follow-up. We compared our data with those of the Traumatic Brain Injury Model System Data Base (TBI MSDB) and Gruppo Italiano per lo Studio delle Cerebrolesioni Acquisite Riabilitazione (GISCAR). RESULTS: Disability at one-year follow-up was better than at discharge: increase in FIM value, in DRS value. Social reintegration and return to work were not optimal: CIQ value was 16 and only 38% of patients returned to work at follow-up. Disability and social integration mean scores in our sample were similar to those obtained in TBI MSDB and so were the values of onset-admission interval (OAI) and length of stay (LOS). Differences were found with the Italian GISCAR database where mean OAI and LOS were higher than in our sample (55 and 86 days vs 18 and 37 days). CONCLUSIONS: Our data show that this kind of organizing model for the rehabilitative evolution of TBI patients can positively influence the cost-efficiency rate of rehabilitation process reducing care costs in terms of ICU and rehabilitation LOS without affecting outcome in terms of disability and reintegration.

Adult↗