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PubMed1983

Baccalaureate preparation for medical school: does type of degree make a difference?

Four groups of medical school matriculants (43 with a B.A. degree in social sciences, 68 with a B.A. degree in the humanities, 49 with a B.A. degree in science, and 40 with a B.S. degree in science) were studied. No significant difference was found among the four groups on yearly grade-point averages in medical school or on parts I, II, and III of the examinations of the National Board of Medical Examiners. Those with an undergraduate degree in the humanities considered leaving medical school more frequently than the others. A substantial proportion of medical students with an undergraduate major in the sciences and social sciences reported they would choose the humanities if they were once again high school seniors. Those with a science background were disproportionately more likely than the others to choose residencies in internal medicine and surgery, and those with undergraduate degrees in the humanities and social sciences were more likely to choose psychiatry residencies.

Achievement↗
PubMedDate not supplied

Social and professional support for pregnant and parenting women.

PURPOSE: A literature review to contrast the role of social and professional support in improving maternal and infant outcomes in pregnant and parenting women. In addition, recommendations are made for future research and policy and program development concerning support needed by pregnant and parenting women. DATA SOURCES: Data were limited to published studies. Searches of computerized databases, hand searches of journals, and backward searches from reference lists of studies were conducted. Nursing, medicine, psychology, public health, sociology, and social work literatures were searched (CINAHL, Medline, PsychLit, Social Sciences Abstracts, Social Sciences Citation, and Social Work Abstracts). STUDY SELECTION: The studies focused on outcomes of social support and professional support to pregnant and parenting women. The samples of the studies included pregnant women and parenting women up to 2 years postpartum. Studies reviewed were conducted in the United States or Canada and included maternal and/or infant outcomes. All ages and races of pregnant and parenting women were considered. DATA EXTRACTION: Data were extracted from each study concerning the theoretical framework, variables, sample, design, measuring instruments, interventions, and outcomes. DATA SYNTHESIS: Social support outcomes were summarized in paragraphs while a table was used to summarize professional support intervention outcomes. CONCLUSIONS: Outcomes associated with specific support interventions should be clearly identified, informed by theory, and include assisting the pregnant and parenting woman to improve her social support.

Clinical Competence↗
PubMedDate not supplied

Paraprofessional support for pregnant & parenting women.

PURPOSE: To review evidence regarding the role of paraprofessional support in improving maternal and infant outcomes in pregnant and parenting women. Although support provided by significant others (social support), by professionals, and by paraprofessionals are frequently considered together in literature reviews, this is inappropriate because the components of the support in each case differ. DATA SOURCES: Data were limited to published studies. Searches of computerized databases (CINAHL, Medline, PsychLit, Social sciences abstracts, Social sciences citation, and Social work abstracts), hand searches of journals, and backward searches from reference lists of studies were conducted. Nursing, medicine, psychology, public health, sociology, and social work literatures were searched. STUDY SELECTION: The studies included had statistically significant outcomes of paraprofessional support to pregnant and parenting women. Studies were published in 1985 or later, were conducted in the United States or Canada, and included maternal and/or infant outcomes. DATA EXTRACTION: Data were extracted from each study concerning the theoretical framework, design, sample, measuring instruments, interventions, and outcomes. CONCLUSIONS: Programs providing paraprofessional support to childbearing women are clearly providing an important service, but empirical evidence is not adequate to determine which specific paraprofessional program works for a specific population of women to achieve the best long-term outcomes for both women and children. Although proponents of paraprofessional support programs for pregnant and parenting women have reported some successes, more data are needed. Researchers should continue to conduct well-designed and controlled studies to compare outcomes from the three types of support. Nurses in practice should build on services provided by paraprofessionals in order to meet women's need for support and to achieve desired outcomes.

Community Health Services↗
PubMed1999

Educating medical students for work in culturally diverse societies.

CONTEXT: Recent attention has focused on whether government health service institutions, particularly in the United Kingdom, reflect cultural sensitivity and competence and whether medical students receive proper guidance in this area. OBJECTIVE: To systematically identify educational programs for medical students on cultural diversity, in particular, racial and ethnic diversity. DATA SOURCES: The following databases were searched: MEDLINE (1963-August 1998); Bath International Data Service (BIDS) Institute for Scientific Information science and social science citation indexes (1981-August 1998); BIDS International Bibliography for the Social Sciences (1981-August 1998); and the Educational Resources Information Centre (1981-August 1998). In addition, the following online data sets were searched: Kings Fund; Centre for Ethnic Relations, University of Warwick; Health Education Authority; European Research Centre on Migration and Ethnic Relations, University of Utrecht; International Centre for Intercultural Studies, University of London; the Refugee Studies Programme, University of Oxford. Medical education and academic medicine journals (1994-1998) were searched manually and experts in medical education were contacted. STUDY SELECTION: Studies included in the analysis were articles published in English before August 1998 that described specific programs for medical students on racial and ethnic diversity. Of 1456 studies identified by the literature search, 17 met the criteria. Two of the authors performed the study selection independently. DATA EXTRACTION: The following data were extracted: publication year, program setting, student year, whether a program was required or optional, the teaching staff and involvement of minority racial and ethnic communities, program length, content and teaching methods, student assessment, and nature of program evaluation. DATA SYNTHESIS: Of the 17 selected programs, 13 were conducted in North America. Eleven programs were exclusively for students in years 1 or 2. Fewer than half (n = 7) the programs were part of core teaching. Only 1 required program reported that the students were assessed on the session in cultural diversity. CONCLUSIONS: Our study suggests that there is limited information available on an increasingly important subject in medical education. Further research is needed to identify effective components of educational programs on cultural diversity and valid methods of student assessment and program evaluation.

Cultural Diversity↗
PubMed2005

The versatility of progress testing assessed in an international context: a start for benchmarking global standardization?

Sharing and collaboration relating to progress testing already takes place on a national level and allows for quality control and comparisons of the participating institutions. This study explores the possibilities of international sharing of the progress test after correction for cultural bias and translation problems. Three progress tests were reviewed and administered to 3043 Pretoria and 3001 Maastricht medical students. In total, 16% of the items were potentially biased and removed from the test items administered to the Pretoria students (9% due to translation problems; 7% due to cultural differences). Of the three clusters (basic, clinical and social sciences) the social sciences contained most bias (32%), basic sciences least (11%). The differences that were found, comparing the student results of both schools, seem a reflection of the deliberate accentuations that both curricula pursue. The results suggest that the progress test methodology provides a versatile instrument that can be used to assess medical schools across the world. Sharing of test material is a viable strategy and test outcomes are interesting and can be used in international quality control.

Benchmarking↗
PubMedDate not supplied

The Newtonian mechanistic paradigm, special education, and contours of alternatives: an overview.

The concept of paradigm as a set of ontological and epistemological benchmarks is the basis for a discussion of the influence the Newtonian mechanistic paradigm has exerted over special education theory, research, and practice. Discussions of "malcontents" with the mechanistic paradigm across the social sciences and within special education are noted. Recent literature in the field of special education is critiqued for renaming theories as paradigms, thereby leaving mechanistic assumptions in place. The contours are then drawn of theoretical reorientations and of the emerging alternative holistic paradigm and its importance for special education. It is concluded that we do not have paradigms or paradigm shifts within the field, but that the field is part of a paradigm that is undergoing change across the sciences and social sciences.

Child↗
PubMed1982

[The effect of science on policy for the elderly].

Social policy for the elderly is individualistic and limited to offering the use of social services. This is related to scientific paradigms. Social science has an important influence on the definition of well-being by social policy agencies and in society. This influence has the side-effect of transferring the limited scientific view on reality to social policy and social services. To prevent negative effects on the well-being of the elderly population, there is a need of ethical norms for social science research. Social science is increasingly a collective activity, for example by means of research programs. That is the reason why the individual ethical norms of the research-worker are not sufficient. Proposed is the development of a collective social ethic for social research. This ethic would guarantee that scientists are concerned with the totality of human needs, with the desirability of continuity in the life situation of people, and with future generations.

Aged↗
PubMed2001

Dietary advice given by a dietitian versus other health professional or self-help resources to reduce blood cholesterol.

BACKGROUND: The average level of blood cholesterol is an important determinant of the risk of coronary heart disease. Blood cholesterol can be reduced by dietary means. Although dietitians are trained to provide dietary advice, for practical reasons it is also given by other health professionals and occasionally through the use of self-help resources. OBJECTIVES: To assess the effects of dietary advice given by a dietitian compared with another health professional, or the use of self-help resources, in reducing blood cholesterol in adults. SEARCH STRATEGY: We searched The Cochrane Library (to Issue 2 1999), MEDLINE (1966 to January 1999), EMBASE (1980 to December 1998), Cinahl (1982 to December 1998), Human Nutrition (1991 to 1998), Science Citation Index, Social Sciences Citation Index, hand searched conference proceedings on nutrition and heart disease, and contacted experts in the field. SELECTION CRITERIA: Randomised trials of dietary advice given by a dietitian compared with another health professional or self-help resources. The main outcome was difference in blood cholesterol between dietitian groups compared with other intervention groups. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Eleven studies with 12 comparisons were included, involving 704 people receiving advice from dietitians, 486 from other health professionals and 551 people using self-help leaflets. Four studies compared dietitian with doctor, seven with self-help resources, and one compared dietitian with nurse. Participants receiving advice from dietitians experienced a greater reduction in blood cholesterol than those receiving advice only from doctors (-0.25 mmol/L (95% CI -0.37, -0.12 mmol/L)). There was no statistically significant difference in change in blood cholesterol between dietitians and self-help resources (-0.10 mmol/L (95% CI -0.22, 0.03 mmol/L)). No statistically significant differences were detected for secondary outcome measures between any of the comparisons with the exception of dietitian versus nurse for HDLc, where the dietitian groups showed a greater reduction (-0.06 mmol/L (95% CI -0.11, -0.01)). No significant heterogeneity between the studies was detected. REVIEWER'S CONCLUSIONS: Dietitians were better than doctors at lowering blood cholesterol in the short to medium term, but there was no evidence that they were better than self-help resources. The results should be interpreted with caution as the studies were not of good quality and the analysis was based on a limited number of trials. More evidence is required to assess whether change can be maintained in the longer term. There was no evidence that dietitians provided better outcomes than nurses.

Cholesterol↗
PubMed1994

Setting up a scientific community by means of a small grants program: the Latin American experience.

The study of tropical diseases in Latin America has been dominated by the biomedical sciences, and whilst recently social science health research has been developed, there has been little collaboration between the two. The Latin American Small Grants Programme for Social and Economic Aspects of Tropical Diseases, launched by WHO/TDR in 1990, aimed to attract junior researchers into the area of social sciences and tropical diseases, and to create among them a scientific community. The program is unique in that it has involved the transfer of decision-making power from an international organisation (WHO/TDR) to a regional group. This article discusses the organisational structure of the program, the methods by which the program handled proposals, the evaluation process, the types of research proposals received, a profile of applicants, and the results of the applications. There was a balance of biomedical and social science applications. We conclude that the Small Grants Programme has been successful in fulfilling its objectives, due to the design of the grants scheme itself.

Financing, Organized↗
PubMed1996

Public health research and lay knowledge.

Social science research into the social patterning of health and illness is extensive. One important aspect of this has been work on lay knowledge about health and illness. In this paper we develop three main arguments. First, we suggest that recent developments in social science understanding of the nature and significance of lay knowledge should be more widely recognized within the social sciences themselves. Second, we argue that if public health research, whatever the disciplinary perspective, is to provide an understanding of contemporary health problems that is simultaneously more robust and more holistic, it must incorporate and develop the theoretical and conceptual insights offered by this recent work on lay knowledge and with lay people. Finally, we argue that in order to accomplish this it will be necessary to construct research questions in such a way that the conventional distinctions between science and non-science, and the methodological wrangles associated with this distinction, become marginal to the research process. This will inevitably involve conflicts between members of different professional groups. These conflicts provide the opportunity for open debate on the science and politics of public health research and represent a challenge for the many disciplines involved in this field.

Forecasting↗
PubMed1996

Afrocentricity: an emerging paradigm in social work practice.

Although several models of social work practice that can better assist people of color have emerged, the cultural values of this population generally have not been used as a theoretical base to develop new practice models. This situation not only prevents a truly diversified theoretical base in social work but also reinforces the hegemony of Eurocentric concepts for explaining and solving human and societal problems. Recently the concept "Afrocentricity" has been used to describe the cultural values of people of African descent. This article presents the values and describes the philosophical concepts of Afrocentricity as a social science paradigm on which social work practice can be conceived and built and explains the reasons for the emergence of an Afrocentric social science perspective. Social workers are encouraged to embrace the Afrocentric paradigm because of its emphasis on eliminating oppression and spiritual alienation.

Africa↗
PubMed1967

The premedical education of the first-year class in Canadian medical schools: 1965-66.

The premedical academic records of the 1965-66 entering class of Canadian medical students were analysed. Ninety-six per cent of the class had taken their preparation in a Canadian institution, while 80% had taken it in the same university as the medical school in which they enrolled. Forty per cent entered without a degree, the remainder having at least a bachelor's degree in arts or science.Thirty-six per cent of all courses taken by these students in their premedical education were in the physical sciences, 22% in the biological sciences and 41% in the social sciences and humanities. One-third of the students had taken no course in the behavioural sciences and another third had taken only one course.Analysis of the level of performance of the entering class showed that 10% had obtained an A average, 49% a B average, 41% a C average and 3% a D average. The grades of these students were higher generally in the natural sciences than in the social sciences or humanities.It was concluded that it could be questioned whether medical students received a premedical preparation which met the philosophy of a "broad, liberal education".

Adult↗
PubMed2006

Personality traits and university program.

Participants were 147 undergraduates majoring in programs classified as more professional (education, n = 28; business, n = 33) or less professional (natural sciences, n = 36; social science, n = 50) and more people-oriented (education, social sciences) or less people-oriented (business, natural sciences). They completed self-report tests for 13 personality constructs (five from Goldberg's version of the Five Factor Model, three from Eysenck and Eysenck's theory, and five others). Students in less professional disciplines scored higher on openness to experience (intellect/imagination) than those in more professional disciplines. Students in more people-oriented disciplines scored higher on empathy than those in less people-oriented disciplines. Women scored higher than men on conscientiousness, industriousness, and empathy, but lower than men on independence. Critical comments are offered and suggestions for research are made.

Adult↗
PubMed2002

Group-based parent-training programmes for improving emotional and behavioural adjustment in 0-3 year old children.

BACKGROUND: Mental health problems in children are common. Research suggests that parenting has an important role to play in helping children to become well adjusted adults, and that the first few months and years of a child's life are especially important in establishing patterns of emotional, cognitive and social functioning which will in turn influence the child's future development and in particular, their mental health. Parenting programmes may therefore have a role to play in improving the mental health of infants and toddlers. OBJECTIVES: The objectives of this review are as follows: a) To establish whether group-based parenting programmes are effective in improving the mental health of children less than three years of age b) To assess the role of parenting programmes in the primary prevention of mental health problems SEARCH STRATEGY: A range of biomedical and social science databases were searched including MEDLINE, EMBASE, CINAHL, PsychLIT, Sociofile, Social Science Citation Index, ASSIA, the Cochrane Library including SPECTR, CENTRAL, National Research Register (NRR) and ERIC. SELECTION CRITERIA: Only randomised controlled trials were included and studies had to include at least one standardised instrument measuring some aspect of infant mental health. DATA COLLECTION AND ANALYSIS: The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment group, by the pooled standard deviation, to obtain an effect size. The results for each outcome in each study have been presented with 95% confidence intervals. Where appropriate the results have been combined in a meta-analysis using a random effect model. MAIN RESULTS: A total of five studies were included in the review. The 5 included studies provided a total of 36 assessments of infant and toddler mental health including emotional and behavioural adjustment, and sleep patterns. All of the results apart from 6 showed positive findings favouring the intervention group. While some of findings were non-significant, most of the effect sizes were large and the wide confidence intervals crossing the zero that were obtained in a number of the studies, were very probably due to small sample sizes. There was sufficient data from four studies to combine the results in a meta-analysis. The results of the meta-analysis show a significant difference in children's emotional and behavioural adjustment favouring the intervention group. Overall, the limited follow-up data provide equivocal evidence concerning the maintenance of these effects over time. REVIEWER'S CONCLUSIONS: The results of this review suggest that parenting programmes can be effective in improving the mental health of infants and toddlers. There is, however, insufficient evidence to reach any firm conclusions regarding the role that such programmes might play in the primary prevention of mental health problems. Furthermore, there is insufficient evidence to know whether the short-term benefit of these programmes is maintained over time, and further research is required.

Child Development↗
PubMed2001

Positivism and qualitative nursing research.

Despite the hostility to positivism shown by qualitative methodologists in nursing, as in other disciplines, the epistemological and ontological instincts of qualitative researchers seem to coincide with those of the positivists, especially Bayesian positivists. This article suggests that positivists and qualitative researchers alike are pro-observation, proinduction, pro-plausibility and pro-subjectivity. They are also anti-cause, anti-realist, anti-explanation, anti-correspondence, anti-truth. In only one respect is there a significant difference between positivist and qualitative methodologists: most positivists have believed that, methodologically, the natural sciences and the social sciences are the same; most qualitative researchers are adamant that they are not. However, if positivism fails as a philosophy of the natural sciences (which it probably does), it might well succeed as a philosophy of the social sciences, just because there is a methodological watershed between the two. Reflex antagonism to positivism might therefore be a major obstacle to understanding the real reasons why qualitative research and the natural sciences are methodologically divergent; and less hostility on the part of qualitative nurse researchers might bring certain advantages in its wake.

Humans↗