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PubMed1976

Geriatrics in relation to the social and behavioural sciences.

Social and behavioural gerontology is the scientific study of how men and women adapt to their environment as they grow older. It is a multidisciplinary area, comprising subjects each of which asserts an existence in its own right, as a scientific enterprise, apart from other subjects in the area, and apart from geriatrics. Social and behavioural gerontology, however, forms part of the total context within which geriatrics gets its meaning and value. Geriatrics, in turn, affects these other adjacent disciplines. Social and behavioural gerontology could help in a general way by putting geriatrics into this wide perspective and thus demonstrating the wider issues that might otherwise be neglected in the busy round of geriatric care. Social and behavioural gerontology could also help in numerous particular ways such as: the collection of normative data; improved conceptual analysis; better methods of observation, experimentation, measurement and data analysis; the integration of social and behavioural case-work with clinical geriatrics for both treatment and training purposes; improved techniques of social and behavioural assessment; improvements in communication; better social attitldes; increased self-help and understanding of the role of the elderly in society; more effective consumer behaviour; and more effective social policies incorporating long-range, broad-spectrum preventive measures.

Aged↗
PubMed2005

[Gender specificity and interdisciplinarity. Methodological-theoretical observations].

In public, sex specifity of humans is under a lively discussion, dominated by Social Sciences. It could be observed that between the theoretically involved disciplines natural sciences, social sciences and liberal arts exist very little flow of information and discussion. It was pointed out that sex specifity matters several disciplines because of the complexity of the phenomenon, but the research still lacks epistemological prerequisites to apply to this goal. The contribution makes methodological and theoretical remarks in order to promote an interdisciplinary approach. Obstacles from tradition and organisation of research are mentioned as well as dominating epistemological and theoretical advances.

Behavioral Research↗
PubMed1988

Contributions of family violence research to criminal justice policy on wife assault: paradigms of science and social control.

Criminal justice policy on family violence has evolved over the past two decades, informed by political activism as well as theory and research from divergent and often competing perspectives. Experimental research on mandatory arrest of men who assault female partners, policy research on special prosecution programs, and the development of treatment programs for men who batter, typify the strategies for applying criminal sanctions to family violence. However, other critical research on family violence has not been integrated into criminal justice policy, limiting policy development and intervention strategies to practices which reflect contemporary models of sanctions and social control. The limited contributions of family violence research to criminal justice policy reflect competing paradigms of social science, the challenge of family violence cases to the normative processes and the social organization of the criminal courts, and divergent perspectives on social control of offenders in family and stranger violence cases. Strategies for an integrated policy development process are suggested.

Criminal Law↗
PubMed1996

Biological sciences in Project 2000: an exploration of status.

Through Project 2000 preregistration nursing courses it was intended to establish a broad knowledge base for nurse education. This is likely to affect the way biological sciences are viewed as subjects within the curriculum. The aim of this study was to investigate the status of biological sciences in the curriculum following educational reform. A small-scale, descriptive study was undertaken investigating one institution. Quantitative and qualitative data were gathered using a postal questionnaire; this was complemented by contextual information obtained from documents. Findings indicated that there was a lack of consensus amongst teachers regarding what emphasis should be given to different subjects within the curriculum. It was commented that 'nursing' may have been displaced by pure subject disciplines, and that application of biological theory to practice was inadequate. Biological sciences, social sciences and behavioural sciences were allotted equal hours in the curriculum; concern was expressed, however, that there was insufficient time available for some subjects. This appeared to foster competition and tension, in particular between proponents of biological and social sciences. Teachers demonstrated subject loyalty, and promoted their own discipline within the curriculum. In an attempt to explain findings a conceptual framework based upon the sociology of knowledge and conflicts and tensions between groups within a profession was employed. Issues identified in the study suggest that there is cause for concern with respect to the structuring, teaching and learning of biological concepts, and their application to nursing practice.

Biological Science Disciplines↗
PubMed2001

How to unify knowledge. Keynote address.

The central question of general scholarship is whether all of knowledge is intrinsically consilient, that is, whether it can be united by a continuous skein of cause-and-effect explanation and across levels of increasingly complex organization. The answer lies in the recognition that the traditional line separating the great branches of learning (natural sciences, social sciences, and humanities) is not a barrier or even a line, but rather a broad domain of poorly explored material phenomena now being cooperatively entered from all sides. The key to bridge-building is the discovery and analysis of human nature, which consists of the epigenetic rules--the hereditary regularities in mental development. Their study is now well under way, at the biological, social science, and humanities levels. Examples of epigenetic rules include the origin of color vocabularies, incest avoidance, optimum arousal in artistic design, and response to the natural environment. The convergence of the great branches of learning is mostly an empirical process, light on formal logic and theory in its initial stages. The value of the consilience program is that at long last we appear to have acquired the means either to establish the intrinsic truth of the fundamental unity of knowledge, or to discard it. I will argue the likelihood of its existence and early establishment.

Behavior↗
PubMed1998

Course-based assessment: implementing outcome assessment in medical education.

Rapid, intensive change in the health care system requires a change in how the outcomes of medical education are measured. The post-Flexner model of evaluating the institution focuses on teaching (rather than learning) and is not relevant to ambulatory training. Medical education needs to use assessment that focuses on student learning, can respond quickly to changes, and is continuously refined by use of information about students' abilities. Course-based assessment is a systematic way to gather, analyze, disseminate, and use course data to improve student learning, and it is well suited to current trends in health professions education. The authors present and discuss six principles of effective outcome assessment in medical education and illustrate these principles from their experience of using this type of assessment in a pre-clinical course integrating basic science, social science, and clinical skills. Courses and programs for medical students and residents should use course-based assessment to ensure that medical trainees acquire the skills and attitudes needed to practice medicine well. The next challenge for medical educators is to implement course-based assessment that is intimately tied to a broader institutional plan.

Attitude of Health Personnel↗
PubMed2004

[Mechanism analysis of optimized model of conversion from farmland to forestland in the hill-gully sub-region of Loess Plateau].

Conversion from Farmland to Forestland Program (CFF) is one of the six great ecological forest programs in China. This study covered the CFF model area of the hilly-gully sub-region of loess plateau, and introduced system dynamics and other latest theories and methodologies. Based on the analysis of five modules including that of the site observation of field stations and extensive investigations, and over 10000 original data obtained in the fields of natural science, social science and economics, the operational mechanism of the optimized model was studied. The optimized operational models integrated maximized ecological, economic and social benefits, while sustainability concepts were proposed for typical CFF sites: The Pinus tabulaeformis + Platycladus orientalis + Zanthoxylum spp. + Robinia pseudoacacia model at the eroded flat ridges of the middle reaches of the Yellow River. The result showed that the ecological, economic and social benefits of the optimized model reflected by main indexes were the best or better, and in the other models, either individual one was the best or others were not. From the viewpoint of comprehensive comparison of three great benefits, the optimized model was most excellent, and had eminent difference comparing to other ones through F test. The relationship between ecological and social benefit was eminent positive correlative. Social benefit was the same with economical one at some degrees. The relationship between ecological and economical benefit was more complicated. On the whole, they were positive correlative, but the economical benefit was not the greatest when the ecological one was the greatest. In general, from the viewpoint of largest comprehensive benefit, the three great benefits were not all the best, indicating that the combination of the modules must be reasonable. In order to achieve the ultimate goal of CFF, we must choose the optimized combination of ecological, economical and social benefits, and can't only pursue any one maximum of three great benefits.

China↗
PubMed2003

Issues in environmental water allocation--an Australian perspective.

Environmental water allocation is a critical issue in Australia and internationally. It has been prominent in Australia for a little over ten years during which time major policy and scientific advances have been made, but little implementation. This paper examines current understanding of environmental water allocation across a broad range of disciplines including the biophysical sciences, social sciences, economics, law, and policy. Development of practical methods for assessing environmental water requirements and experience with implementation in Australia are discussed. The paper concludes with thoughts on future needs.

Australia↗
PubMed2002

Surgery for varicose veins: use of tourniquet.

BACKGROUND: Varicose vein surgery is a common surgical procedure but there is no consensus regarding the best surgical technique. The use of tourniquets during varicose vein surgery has been advocated as a means of reducing the potential for blood loss during the operation. OBJECTIVES: To identify whether the use of a tourniquet should be recommended when undertaking surgery for the management of primary varicose veins. SEARCH STRATEGY: The reviewers searched the Cochrane Peripheral Vascular Diseases Group trials register (last searched November 2001), thirteen electronic bibliographic databases, including the Cochrane Controlled Trials Register (CCTR) (last searched Issue 3, 2001), covering biomedical science, social science, health economic and grey literature (including current research). In addition, the reference lists of relevant articles were checked and various health services research related resources were consulted via the Internet. These included health economics and HTA organisations, guideline producing agencies, generic research and trials registers, and specialist sites. SELECTION CRITERIA: All studies described as randomised controlled trials that examined the use of tourniquets during surgery for patients with primary varicose veins were included. DATA COLLECTION AND ANALYSIS: Data from eligible studies were extracted and summarised independently by two reviewers. All studies were cross-checked independently by the reviewers. MAIN RESULTS: A total of twenty published papers and nineteen studies were identified. Only three of these were randomised controlled trials and were included in the review. Sixteen studies were excluded as they were non-randomised and one was a duplicate study. All three trials had a small sample size and reported the trial design, outcome measures and analysis poorly. There were also variations in the outcome measures used between the trials. In addition, there was no consistency on the reporting of mean and medians for blood loss during the operation. It was therefore not possible to pool the data to perform meta-analysis. However, the reported blood loss when using a tourniquet was between 0 and 16mls compared to between 107 to 133mls when not using a tourniquet (p<0.01). REVIEWER'S CONCLUSIONS: Although there were significant quality issues with the available evidence, the use of a tourniquet would appear to reduce blood loss during surgery. There were no reported differences between the use or non-use of a tourniquet in terms of complications and morbidity. However, the available trials were not of sufficient size to detect rarer complications such as nerve damage.

Blood Loss, Surgical↗
PubMed2004

Surgery versus sclerotherapy for the treatment of varicose veins.

BACKGROUND: Varicose veins are a relatively common condition and account for around 54,000 in-patient hospital episodes per year. The two most common interventions for varicose veins are surgery and sclerotherapy. However, there is little comparative data regarding their effectiveness. OBJECTIVES: To identify whether the use of surgery or sclerotherapy should be recommended for the management of primary varicose veins. SEARCH STRATEGY: Thirteen electronic bibliographic databases were searched covering biomedical, science, social science, health economic and grey literature (including current research). In addition, the reference lists of relevant articles were checked and various health services research-related resources were consulted via the internet. These included health economics and HTA organisations, guideline producing agencies, generic research and trials registers, and specialist sites. SELECTION CRITERIA: All studies that were described as randomised controlled trials comparing surgery with sclerotherapy for the treatment of primary varicose veins were identified. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted and summarised data from the eligible studies using a data extraction sheet for consistency. All studies were cross-checked independently by the reviewers. MAIN RESULTS: A total of 2306 references were found from our searches, 61 of which were identified as potential trials comparing surgery and sclerotherapy. However, only nine randomised trials, described in a total of 14 separate papers, fulfilled the inclusion criteria. Fifty trials were excluded and one trial is ongoing and is due for completion in 2004. The trials used a variety of outcome measures and classification systems which made direct comparison between trials difficult. However, the trend was for sclerotherapy to be evaluated as significantly better than surgery at one year; after one year (sclerotherapy resulted in worse outcomes) the benefits with sclerotherapy were less, and by three to five years surgery had better outcomes. The data on cost-effectiveness was not adequately reported. REVIEWERS' CONCLUSIONS: There was insufficient evidence to preferentially recommend the use of sclerotherapy or surgery. There needs to be more research that specifically examines both costs and outcomes for surgery and sclerotherapy.

Humans↗
PubMed2004

What is social capital and how does it relate to health?

During the last 25 years, a new term has cropped up in social sciences, social capital. In the last 10 years, this term acquired a new dimension which relates it to health. Following an analysis of theoretical issues surrounding social capital and social support, recent research is used to illustrate how these are affecting health. It is argued that more theoretical development is needed before social capital can be used to form a new community nursing practice. Until then, the ideas of social capital (social contact, companionship, etc.) may guide our mode of operation during nursing interventions.

Community Health Nursing↗
PubMed2004

Mixed-membership models of scientific publications.

PNAS is one of world's most cited multidisciplinary scientific journals. The PNAS official classification structure of subjects is reflected in topic labels submitted by the authors of articles, largely related to traditionally established disciplines. These include broad field classifications into physical sciences, biological sciences, social sciences, and further subtopic classifications within the fields. Focusing on biological sciences, we explore an internal soft-classification structure of articles based only on semantic decompositions of abstracts and bibliographies and compare it with the formal discipline classifications. Our model assumes that there is a fixed number of internal categories, each characterized by multinomial distributions over words (in abstracts) and references (in bibliographies). Soft classification for each article is based on proportions of the article's content coming from each category. We discuss the appropriateness of the model for the PNAS database as well as other features of the data relevant to soft classification.

Biology↗
PubMed2005

Statistical-mechanical iterative algorithms on complex networks.

The Ising models have been applied for various problems on information sciences, social sciences, and so on. In many cases, solving these problems corresponds to minimizing the Bethe free energy. To minimize the Bethe free energy, a statistical-mechanical iterative algorithm is often used. We study the statistical-mechanical iterative algorithm on complex networks. To investigate effects of heterogeneous structures on the iterative algorithm, we introduce an iterative algorithm based on information of heterogeneity of complex networks, in which higher-degree nodes are likely to be updated more frequently than lower-degree ones. Numerical experiments clarified that the usage of the information of heterogeneity affects the algorithm in Barabási and Albert networks, but does not influence that in Erdös and Rényi networks. It is revealed that information of the whole system propagates rapidly through such high-degree nodes in the case of Barabási-Albert's scale-free networks.

Journal Article↗
PubMed2003

Ultrasonic locating devices for central venous cannulation: meta-analysis.

OBJECTIVES: To assess the evidence for the clinical effectiveness of ultrasound guided central venous cannulation. DATA SOURCES: 15 electronic bibliographic databases, covering biomedical, science, social science, health economics, and grey literature. DESIGN: Systematic review and meta-analysis of randomised controlled trials. Populations Patients scheduled for central venous access. INTERVENTION REVIEWED: Guidance using real time two dimensional ultrasonography or Doppler needles and probes compared with the anatomical landmark method of cannulation. DATA EXTRACTION: Risk of failed catheter placement (primary outcome), risk of complications from placement, risk of failure on first attempt at placement, number of attempts to successful catheterisation, and time (seconds) to successful catheterisation. DATA SYNTHESIS: 18 trials (1646 participants) were identified. Compared with the landmark method, real time two dimensional ultrasound guidance for cannulating the internal jugular vein in adults was associated with a significantly lower failure rate both overall (relative risk 0.14, 95% confidence interval 0.06 to 0.33) and on the first attempt (0.59, 0.39 to 0.88). Limited evidence favoured two dimensional ultrasound guidance for subclavian vein and femoral vein procedures in adults (0.14, 0.04 to 0.57 and 0.29, 0.07 to 1.21, respectively). Three studies in infants confirmed a higher success rate with two dimensional ultrasonography for internal jugular procedures (0.15, 0.03 to 0.64). Doppler guided cannulation of the internal jugular vein in adults was more successful than the landmark method (0.39, 0.17 to 0.92), but the landmark method was more successful for subclavian vein procedures (1.48, 1.03 to 2.14). No significant difference was found between these techniques for cannulation of the internal jugular vein in infants. An indirect comparison of relative risks suggested that two dimensional ultrasonography would be more successful than Doppler guidance for subclavian vein procedures in adults (0.09, 0.02 to 0.38). CONCLUSIONS: Evidence supports the use of two dimensional ultrasonography for central venous cannulation.

Adult↗
PubMed1984

The influence of early malnutrition on subsequent behavioral development III. Learning disabilities as a sequel to malnutrition.

The academic performance of 129 Barbadian children (77 boys and 52 girls), who were 5-11-yr-old and suffered moderate to severe protein-energy malnutrition in the first year of life, was compared with the performance of matched comparisons, children who had no history of malnutrition. Children with a history of malnutrition were found to have lower performance on eight out of nine academic subject areas, namely, language arts, mathematics, general science, social science, reading, health, religion, and arts/crafts. Socioeconomic factors in the backgrounds of the children were also examined. A model is presented clarifying the interrelationships of malnutrition, socioeconomic status and school performance. Reduced school performance in the previously malnourished children can be largely accounted for by deficits in classroom behavior, and, to a lesser extent by a reduction in I.Q. Current socioeconomic status is not directly involved in altering academic performance whereas the early history of malnutrition and its accompanying conditions at the time of the illness are leading contributors to altered behavioral outcome and school performance.

Analysis of Variance↗
PubMed2001

The comparative performance of for-profit and nonprofit home health care services in the US.

OBJECTIVE: To determine, by way of an exhaustive, systematic, and comprehensive review and summary of all scientific published studies, whether or not there are any performance differences between private for-profit and private nonprofit home health care providers. The second objective is to discover the proportion of all research on this topic that is devoted to home health care services compared to all other health services providers. DATA SOURCES: Computerized bibliographic searches of relevant databases and published indexes and abstracts were undertaken. They included Medline (Ovid and Pubmed versions), Web of Science (Social Sciences Citation Index and Science Citation Index), ABI/Inform, and Sociological Abstracts. Follow-up searches of reference lists in each article obtained from the computerized search were then completed. STUDY DESIGN: This systematic review retained for analysis all published studies that compared the performance of for-profit and nonprofit health care providers on access, quality, cost/efficiency, and/or amount of charity care, based on data collected after 1980. As a quality control measure only studies published in peer reviewed journals were included. Studies were coded according to the article's stated conclusions: for-profit superiority, nonprofit superiority, or no difference/mixed results. PRINCIPAL FINDINGS: The comparative performance of for-profit and nonprofit home health service organizations is one of the most understudied areas of health care provider services in the US today. Only 6 of the over 1030 comparisons of the two concerned home health care. No data on this topic have been collected since 1991, and no articles about it have been published in a peer-reviewed journal since 1995. CONCLUSION: Research on the relative performance of for-profit and nonprofit home health care services is a research priority urgently in need of attention.

Efficiency, Organizational↗
PubMed1996

[Longevity science research retrieval system using the thesaurus specifically developed for the science].

Gerontology is a new field including various disciplines such as medicine, engineering science, social science etc, and is sometimes called as "longevity science". Because of the wide area of the field, it is important to show the scope of the science and the development of its thesaurus contributes to this end. We developed a relevant thesaurus based on the research funded by Longevity Science Promotion Organization, and using the thesaurus, we also developed a database and retrieval system of the gerontology research. This system can be accessed on the Internet.

Aged↗
PubMed1986

Industry, doctors and bureaucracy.

The central actors on the health arena are industry, doctors and bureaucracy. Whilst general trends towards industrialization, professionalization and bureaucratization are not limited to the health field, developments there have been extremely rapid and show unique features. The three actors often cooperate in harmony despite different goals. On the other hand, bureaucracy is often unable to reach its goals because of resistance from the other two actors. Conflicts, however, occur and are intensive in many third world countries. In industrial countries, too, trade interest in pharmaceuticals may over-ride public health considerations. Conflicts concerning individual drugs have received much publicity. In general, doctors as an organized profession tend to protest against bureaucracy but not against industry. In recent years it has become more and more apparent that health issues cannot be treated as the internal affairs of the actors. New actors have entered the arena. Patients' and consumers' organizations, small groups of doctors and new bodies such as Health Action International have changed the scene. Acting together with fundamental societal changes, this adds a new dimension to the debate and raises the question of including a social element in doctors' ethics. Medical research will also be more directed towards the health care system and become closer to the traditional problems of social science. Social scientists will therefore have contributions to make - studying how the relations between the actors influence the health care system and public health, for instance.

Delivery of Health Care↗