Guest editors' introduction: in pursuit of the social determinants of health: the evolution of health services research.
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OBJECTIVE: To analyze the evolution of social inequalities in health in Catalonia (Spain) in the last 20 years. METHODS: Mortality in 354 small areas of Catalonia (288 cities in Catalonia and 66 health areas in the city of Barcelona) was analyzed for the 1984-98 period. Indicators of self-perceived health status, lifestyles, and health services utilization by social class and gender were compared for 1994 and 2002. Factors related to occupational health, immigration and health, environmental health, and policies to reduce social inequalities in health were also analyzed. RESULTS: Although most health indicators improved, multiple inequalities in health were found in both 1994 and 2002. These inequalities were the same in 2002 as in 1994 or, in some cases, worse. The collectives with the worst indicators were persons living in the most deprived areas, those from disadvantaged social classes, women, and immigrants from low-income countries. CONCLUSION: Social inequalities in health have persisted over the past 20 years in Catalonia. We present some recommendations on health information systems, research, and policies to reduce these inequalities.
The ability to recognize and discriminate conspecific faces and facial expressions has played a critical role in the evolution of social communication. Darwin was one of the first to speculate that human and nonhuman primate facial expressions share similar mechanisms for production and functions in expressing emotion. Since his seminal publication, numerous studies have attempted to unravel the meaning of animal signals, with the most success coming from the field of vocal communication, where researchers have identified the referential and emotional nature of specific vocalizations. Studies specifically addressing nonverbal facial displays, however, have faced numerous methodological challenges, including how to objectively describe facial movements and how to study the perception and production of these signals within a social context. In this paper, I will review my studies on chimpanzee face recognition, their ability to categorize facial expressions, and the extent to which chimpanzee facial expressions may convey information about emotion. Finally, recent studies from my lab have begun to address the role of auditory and visual cues in facial expression categorization. Chimpanzees were given the task of matching expressions according to which sensory modality was more salient, the visual or auditory component. For some expressions the visual modality was preferred, while for others the auditory modality was preferred. These data suggest that different social and ecological pressures may shift attention towards one sensory modality over another, such as during long-distance communication or emotional conflict.
Juvenile hormone (JH) exerts pleiotropic functions during insect life cycles. The regulation of JH biosynthesis by neuropeptides and biogenic amines, as well as the transport of JH by specific binding proteins is now well understood. In contrast, comprehending its mode of action on target organs is still hampered by the difficulties in isolating specific receptors. In concert with ecdysteroids, JH orchestrates molting and metamorphosis, and its modulatory function in molting processes has gained it the attribute "status quo" hormone. Whereas the metamorphic role of JH appears to have been widely conserved, its role in reproduction has been subject to many modifications. In many species, JH stimulates vitellogenin synthesis and uptake. In mosquitoes, however, this function has been transferred to ecdysteroids, and JH primes the ecdysteroid response of developing follicles. As reproduction includes a variety of specific behaviors, including migration and diapause, JH has come to function as a master regulator in insect reproduction. The peak of pleiotropy was definitely reached in insects exhibiting facultative polymorphisms. In wing-dimorphic crickets, differential activation of JH esterase determines wing length. The evolution of sociality in Isoptera and Hymenoptera has also extensively relied on JH. In primitively social wasps and bumble bees, JH integrates dominance position with reproductive status. In highly social insects, such as the honey bee, JH has lost its gonadotropic role and now regulates division of labor in the worker caste. Its metamorphic role has been extensively explored in the morphological differentiation of queens and workers, and in the generation of worker polymorphism, such as observed in ants.
This study introduces an individual-based model on a host-parasite assemblage to investigate whether hosts are necessarily selected for obstructing the transmission of virulent parasites to conspecifics. Contrary to the widespread notion, a host's ability to influence parasite transmission within the host population is a neutral character provided that parasite transmission routes are random, with no reference to genetic relatedness. Due to a lack of selection pressure under such circumstances, hosts may fail to evolve counteradaptations against manipulations by parasites to enhance transmission. However, vertically biased transmission (biased toward kin) selects hosts for a decrease of parasite transmission, while it is also known to select parasites to decrease virulence. Horizontally biased transmission routes (biased toward nonrelated conspecifics) select hosts to increase parasite transmission. In this case, their interests coincide with that of their virulent parasites in enhancing transmission to conspecifics. This finding yields the predictions that hosts infected by virulent pathogens, but unable to recover from disease, should be prone to emigrate from their natal territories and also to enhance transmission at a distance from their natal ranges. These results may considerably improve our understanding of the epidemiology of contagious pathogens and the evolution of social and sexual behavior in host species.
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Much of the evolution of social policy in the twentieth century has occurred around conflicts over the scope of markets. To what extent, under what conditions, and for what reasons should we limit the use of markets? Recently, American society has begun to experiment with markets in women's reproductive labor. Many people believe that markets in women's reproductive labor, as exemplified by contract pregnancy, are more problematic than other currently accepted labor markets. I will call this the asymmetry thesis because its proponents believe that there ought to be an asymmetry between our treatment of reproductive labor and our treatment of other forms of labor. Advocates of the asymmetry thesis hold that treating reproductive labor as a commodity, as something subject to the supply-and-demand principles that govern economic markets, is worse than treating other types of human labor as commodities. Is the asymmetry thesis true? And, if so, what are the reasons for thinking that it is true? My aims in this article are to criticize several popular ways of defending the asymmetry thesis and to offer an alternative defense....I focus my discussion on those arguments against contract pregnancy that depend on the asymmetry thesis. I believe that the asymmetry thesis both captures strong intuitions that exist in our society and provides a plausible argument against contract pregnancy.
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Practice of psychiatric hospitalization has considerably changed: deinstitutionnalization, brief hospitalizations, opened units, partnership with patients and complementarity with community mental health services. These changes appear simultaneously in most of industrialized countries. They are the result of social changes, evolution of mental health care, and a sharper perception of deinsertion risks through long term hospitalizations. Values of psychiatric hospital were based on a closed and protective place, where community life prepared to life in the community; they are now founded on an opened place where care aims at resolving crisis and keeping closely in touch with the community. These modifications imply to rethink hospital psychiatric care and their connections with environment. This paper describe a model of care developed in a first admission psychiatric unit.
The article deals with the places of medical art in the antiquity. Author's intention is to give a description of the places where developed the assistance and welfare activity to sick people from the Asklepieia to Monastic Hospitals. In Theurgical Medicine the cure for sickness was peculiar to gods, at first to all gods, mostly to Apollo and Artemide; later healing art had an own god: Asclepius. In the temples of Asclepius, the Asklepieia, prayers, sacrifices, offerings and magical rituals began to be associated with medical practical exercise and rational therapeutic systems. Rational Hippocratic Medicine found own places in the cities: the iatreia in Greece and the tabernae medicae in Rome. The article tries to describe the evolution of social welfare assistance from the Roman Valitudinaria to the monastic xenodochia and the first forms of Religious Hospitals.
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Human violence does not stem from any specific biological substrate. As affective processes play a pre-eminent role in the elaboration and evolution of social interactions, a "biology of violence" draws essentially upon the concepts, methods and techniques of "affective neuroscience".
The factors found in the approach taken towards the disturbances caused by anxiety on the part of the doctors working outside the hospital environment are analyzed. After studying a sample of 45 patients seen consecutively in the outpatient clinica of a general hospital and evaluating their clinical, evolutive, social-demographical characteristics and the type of medical care received previously, we found an important tendency towards diagnostic error which does not seem to be related to the degree of specialization by the medical practitioner who treated the patient. A profile of a patient having a higher risk of receiving and incorrect diagnosis is elaborated.
To evaluate evolutivity and social repercussions of Crohn's disease, the same gastroenterologist interviewed 151 out of 197 patients with Crohn's disease (77.5 percent) who had been hospitalized from 1964 to 1986 in our unit. The other 46 could not be traced or refused to participate. There was no difference regarding age, sex, duration of illness, pattern of lesions and operations between the two groups. At the time of observation, mean follow-up was 7.8 years and two thirds of the patients had inactive disease. During the previous year, the course of the disease was quiescent in 50 percent of all patients; this rate increased with duration of follow-up and time from surgery. A constant rate of stable course was observed (20 percent) irrespective of duration of disease and time of surgery. The interviews were compared with those obtained from an age and sex-matched group of 70 previously healthy subjects admitted to the hospital for less than one month. The education and socioeconomic levels were higher in patients with Crohn's disease than in controls, in spite of the fact that 25 percent of patients whose disease begun during scholarship complained of difficulties at school, and nearly 20 percent of all patients were partially or totally unable to work. Sports and cultural activities were the same in Crohn's disease and in the control group. Tobacco intake was slightly higher at time of diagnosis but it was equal in both groups at the time of the interview. Non allopathic advice or treatment were sought by 48 percent of Crohn's disease patients (7 percent in controls).(ABSTRACT TRUNCATED AT 250 WORDS)
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