Liberty, responsibility, and the common good.
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Altruism↗
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Health care for older persons: a country profile-Korea.
The Korean healthcare system is faced with a crisis caused by rapidly changing social values tending toward westernization, increasing insurance benefit requests for elder health care, financial instability of the National Health Insurance (NHI) program, and a lack of social infrastructure for the elderly. The demand for health care for the elderly has increased markedly, because of a rapidly aging population, growing female participation in the labor market, elevated expectations for health care, and a change in the pattern of medical conditions in the elderly from acute illness to chronic disability. NHI lacks the finances to meet the benefit request for long-term care (LTC). Only 0.39% of the elderly can be accommodated in LTC beds. Consequently, the chronically disabled elderly overflow to acute care beds in general hospitals, which places an undue burden on the already strained NHI system in terms of longer stays and higher cost of treatment in hospitals compared with care specific to the elderly in LTC facilities. It is clear that the Korean healthcare system does not have the facilities to meet such challenges and is in a state of disorder. Korea has failed to predict and prepare for population needs before they arise, including financing and the development of appropriate care models, particularly concerning the adequate provision of LTC. This paper advocates the necessity of international discussion of the prospects for developing health care for aging populations and encourages the sharing of differing national experiences concerning care for the elderly.
Aged↗
[Inhibitive effects of observer's presence on the choice latency].
The purpose of the present experiment was to compare the relative usefulness of drive and self-presentation approaches to social facilitation. Thirty-nine undergraduates were divided into two groups for the experiment. Group 1 was given a delayed choice reaction task under two different conditions. The first session was done with the subjects in isolation, and the second session was done with the subjects in front of an audience. Group 2 was given a delayed choice reaction task under the condition of isolation only. Latency was found to be substantially longer under the audience condition. There were, however, no significant effects on the mean number of the correct responses. These results point to inadequacies in drive approach and give support to self-presentation view, which assumes that subjects may scan more carefully and attempt to exhibit a socially valued behavior in others' presence.
Adult↗
An experience in narrative writing to improve public health practice by students.
The experimental use of the Public Health journal is of value for several reasons. It demonstrates, again, that we may create more positive environments for learning in nursing. We can use techniques from various disciplines in order to get students to use more of their faculties and senses in thinking, problem solving, and communicating. The writing project arose out of the problem students have in assimilating Public Health values, in considering a wider range of alternatives for health care, and in feeling ill at ease with narrative writing and exploration. Since skills in cognition, thought, and writing are interrelated and affect each other, it is appropriate to apply writing methods and examine the outcomes in nursing students' work. The findings support the value of the narrative journal process. Although it does not operate alone in changing student overall response to Public Health in any given semester, it does affect who the students are and what their political-social values are. The students, in general, have been exposed to only traditional, conservative ideas regarding health care delivery and the state's social responsibilities. It is in experimenting with alternative ways to deal with the problems students have in approaching the Public Health model that we further aid them in their struggle to become professional nurse practitioners, who can effectively help people achieve "physical, mental, and social well being," health as defined by the World Health Organization. This is the objective we, as nursing faculty, need to keep before ourselves as a guiding principle at all times.
Education, Nursing, Baccalaureate↗
[Vocational rehabilitation in young mentally retarded adults].
Most of the 151 young feeble-minded adults examined by us prove to be successful at their work-places. In most cases, these work-places require a relatively low degree of qualification. The mentally disabled male persons gain on an average a higher income; often they do heavy physical work and show a higher accident risk than the female persons questioned by us. In a considerable part of the feeble-minded test persons our questioning revealed great differences between the subjective appraisal of their social recognition and the objective appraisal of the social value made by the enterprise. These divergences decrease with increasing age of the test persons. The majority of the oligophrenic young adults are not doing any social work.
Adolescent↗
Searching for a normal life: personal accounts of adults with schizophrenia, their parents and well-siblings.
Using a life course perspective, the research examines personal accounts of adults with schizophrenia, and their parents and well-siblings from six families. Accounts of multiple members of the same family, including the family member with schizophrenia, are used to describe how families understand and accommodate life changes that result from the illness. Families describe the loss of a "normal life" as one of the most devastating aspects of schizophrenia. We present the personal and social losses described by adults with schizophrenia and their well family members, and document families' search for ways that their ill family member can achieve or maintain valued social roles. The concerns of well family members for the future of the ill family member and ways families contemplate transfer of care issues are described. Implications of the study for community research and action are discussed.
Adaptation, Psychological↗
[The hidden side of mental health work.].
Several questions are raised concerning the social values that permeate the changing framework of mental health services and, within these, of the therapeutic relationship. An attempt is made to shed some light on the social dimensions of the symptom and how, in face of which, the framework of the therapeutic relationship translates one of the many facets of social relations.
English Abstract↗
[Several aspects of the development of social public health in Mecklenburg before 1945].
The rise of social hygiene in Mecklenburg before 1945 is described via examples of three scholars of the Rostock University (Julius Uffelmann, Hans Reiter, Werner Kollath). By contextualising this rise, the paper attempts to demonstrate both the transformation of medical items into disciplines and the change of social values of illness and health. This was accompanied by an increasing dissemination of medical-biological values and concepts, from which eugenics emerged and subsequently served as a general model for constructing a well-organised and developing society. Thus a growing number of social disciplines became subjected to these ideas.
Eugenics↗
[Work, schooling, and reproductive health: an ethno-epidemiological study of adolescent women belonging to a birth cohort].
An ethno-epidemiological study was carried out with adolescent women who have been studied since birth. In 2001, all female adolescents from the 1982 Pelotas Birth Cohort were identified in 27% of all census tracts in Pelotas, Rio Grande do Sul State. Risk factors for childbearing during adolescence were investigated using a case-control approach. Cases (n = 420) were identified through the local live birth information system, and controls included 408 women who had not given birth by 2001. To understand social and cultural factors related to childbearing during adolescence, an ethnographic study focused on 23 young women from the case group. Work, schooling, sexuality, and reproductive health were analyzed using an ethno-epidemiological approach. Socioeconomic variables like work and schooling were strongly associated with childbearing in adolescence. An inverse linear association was observed between age at first dating and childbearing during adolescence (p < 0.001). Focusing on the contexts and social values (traditional and/or modern), pregnancy was: a positive consequence of an affective relationship with the partner; a way of exposing adolescent sexuality; and a means to achieve a certain social autonomy and other forms of social status within the age group.
Adolescent↗
[Auditive and somato-sensory event-related potentials in comas: prognostic value for awakening, social and professional reinstatement].
OBJECTIVE: To appreciate prognostical value of event-related potentials in comatose states and the influence of the stimulation's modality. PATIENTS AND METHODS: Thirty-five patients were recorded with the auditory modality whose thirteen were also recorded with the somesthetic modality. They were free of sedation except for five. For 21 patients out of coma, it was possible to get information about their social readaptation 14 months later. RESULTS: When present, cognitive components predict awakening in 100 % of the cases, but only 50 % of the patients who awake had these components. The somesthetic modality seemed to enlarge their detection, but did not improve short-term forecasts. We could not confirm their absence could hamper social reinstatement. CONCLUSION: Event-related potentials are strengthened as having excellent positive prognostic value. Further studies should clarify the interest of the somesthetic modality, and the possibility to get remote prognostic.
Adolescent↗
The significance of contextual factors in valuing health states.
QALY analysis consists of describing the effects of a programme in terms of a stream in a patient-time field after which the stream is evaluated. The stream concept represents a considerable advance compared to for instance describing the outcome of health care in terms of survival rates. The valuation task, on the other hand, poses difficult problems. Several contextual factors may significantly affect the social value assigned to a health improvement in a particular patient-year. None of these factors is included in the current algorithm for calculating social utility in terms of QALYs. The factors are set together in a model that may serve as a framework within which QALY calculations may be considered. Examples are given of how QALY calculations can be misleading if these factors are not taken into account.
Attitude to Health↗
Lessons drawn from observing young peers together.
Based on studies during the past 13 years of what transpires between young peers, lessons are drawn about the nature of human sociability and the development of social skill during the first three years of life. Peer encounters have proven especially helpful for discovering the forms of sociability and social skill the infant is capable of without the aid of a more skillful social partner. From early in infancy, children are quite sociable with peers (age-mates), both in novel play settings and in their own home or customary group care settings, both with an unfamiliar peer and with those quite familiar, both at the start of acquaintanceship with a particular peer and after many encounters with that peer. Their sociability is seen in their attraction to peers, their directing to peers of such distinctively social behaviors as vocalizations, smiles, and gestures, and the predominantly friendly nature of their behavior. Peer encounters in the absence of customary play materials refute claims that attraction to peers is a by-product of interest in toys and the inanimate spectacles peers create through their actions on toys. Distinctions should be drawn between sociability and social skills, especially interactive skills. Interactive skills are systematic ways the young child relates his/her own behavior to the details of a partner's behavior that function to facilitate such valued social outcomes as the generation of a cooperative game or a conversation or the resolution of a dispute. Observations of young peers highlight the distinctive nature of the infant's interactive skills. Social influence between peers is present from 6 months, but rarely takes the form customary for older children. Joining a peer and manipulating the same play material as the peer are rudimentary interactive skills that emerge by 12 months. Interactive skills enabling the generation of extended sequences of social interaction on a common cooperative theme progress rapidly during the third year of life. The distinctive form of the young child's interactive skills produces distinctive patterns of interaction among young peers. Their interactions are managed largely nonverbally well into the third year of life, and extended cooperative interactions most often take the form of games in which one or both children imitate each other's actions. Despite the predominance of imitation, their encounters are also marked by complementary role relationships. The distinctive features of peer encounters prompt speculations about the role peer encounters can play in early development.
Child, Preschool↗
Use of coca leaf in southern Peru: adaptation or addiction.
Use of coca leaves among the Quechua Indians of the Peruvian altiplano is considered from the biological and social perspectives. Biologically, coca use seems to reduce the loss of body heat in the cold and to enhance working ability to a small degree. It may also have nutritional value. Socially, coca is well integrated into the economic and social systems, providing functions in both spheres. The equation of coca use with cocaine addiction is also considered and a simple equivalence is rejected.
Adaptation, Physiological↗
Through the community looking glass: reevaluating the ethical and policy implications of research on adolescent risk and sociopathology.
Drawing on a conception of scientists and community members as partners in the construction of ethically responsible research practices, this article urges investigators to seek the perspectives of teenagers and parents in evaluating the personal and political costs and benefits of research on adolescent risk behaviors. Content analysis of focus group discussions involving over 100 parents and teenagers from diverse ethnic and socioeconomic backgrounds revealed community opinions regarding the scientific merit, social value, racial bias, and participant and group harms and benefits associated with surveys, informant reports, intervention studies, blood sampling, and genetic research on youth problems. Participants comments highlight new directions for socially responsible research.
Adolescent↗
Corrections officers and acquired immune deficiency syndrome: balancing professional distance and personal involvement.
In this article the dynamic between professional distance and personal involvement is examined. Interviews were performed with New York City Correction Department officers who work with acquired immune deficiency syndrome (AIDS) patients on prison hospital wards to determine how they relate to inmates, to inmates who are dying, and to inmates who are dying of AIDS-related illnesses. The article focuses on the degree to which identification with inmates occurs and, as a consequence, how much grief is generated by their deaths. Grief is mediated by: (a) the social organization of prison work; (b) the social construction of AIDS; (c) magic and mythology related to AIDS; (d) corrections officers' occupational ideology; (e) social values; and (f) American attitudes toward death.
Acquired Immunodeficiency Syndrome↗
Measuring the social importance of concentration or dispersion of individual health benefits.
In this paper we address the importance of distributive preferences in the social valuation of quality-adjusted life years (QALYs). We propose a social welfare function that generalises the functions traditionally used in the health economic literature. The novelty is that, depending on the individual health gains, this function can represent either preferences for concentrating or preferences for spreading total gain or both together, an issue which has not been addressed until now. Based on an experiment, we observe that this generalisation provides a suitable approximation to the sampled social preferences.
Consumer Behavior↗
The making of a Munchausen.
The author presents a developmental case history of a Munchausen patient in an effort to understand the evolution of the behavioural patterns associated with the syndrome. The case history documents a pattern of behaviour characterized by: frequent hospitalizations for diffuse ailments, beginning in infancy and persisting into adulthood; inadequate acquisition of appropriate social values and behaviours within the context of the nuclear family; persistent difficulties in adjusting to the demands of school, as expressed in poor academic performance, delinquent behaviour, and poor peer relationships; conflicted social role behaviour regarding work performance, criminal behaviour, and increased abuse of health care services; eventual severance of family ties and the adoption of a 'hobo' life-style which utilizes hospitals for social support and personal definition. This case is compared with a similar study, recently published, and the affinities between the developmental histories and diagnostic criteria descriptive of 'antisocial personality disorder' are emphasized.
Adolescent↗
The moral status of animals and their use in research: a philosophical review.
In this article I offer a philosophical review of (1) leading theories of the moral status of animals, (2) pivotal theoretical issues on which more progress needs to be made, and (3) applications to the setting of animal research. Such an examination demonstrates, I believe, that the practical implications of leading theories converge far more than might be expected. In addition, I hope this review helps to clarify particularly troubling issues that remain so they can be treated adequately.
Animal Experimentation↗