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[The historical evolution of obstetrician formation].

The evaluation of the historical development of obstetrician formation presents features of great modernity. At the end of the XVIII century in Florence the first School of Obstetrics for midwives was established. In the School two relevant complementary formative approaches were privileged: ex cathedra didactics and clinical training. The basic tools for these educational methodologies were constituted by handbook production and by wax anatomical models, the latter a field for the meeting and confrontation of surgeons and craftsmen. The historical-social scenario in which this original evolution took place was Tuscany society in the period of Enlightenment, that promoted the formation of professional figures capable of managing natural childbirth in an autonomous way, while nevertheless placing them under a previously lacking health policy control. In this cultural environment particularly impressive was the influence of J.P. Frank (Austria and Lombardy), but also present were other forces, deriving from other European countries, that aimed at including the formation of obstetricians in a scientific programme, thus excluding an unguarded non-structured training.

Education, Medical↗

Brood care in halictine bees.

Four species of the halictine bee genus Evylaeus keep their brood cells open during most or part of the development of the larvae. In the colonial summer phase, house bees care for the young and keep brood cells clean from feces and exuviae. Progressive feeding of nector is present at least in Evylaeus malachurus, whose fully fed larvae are, on an average, 60 percent heavier than the egg-and-pollen stage. Interactions between the two generations of social Halictinae are of general occurrence, and their intensity corresponds to the level of social behavior attained.

Animals↗

[The cost of cancer in France: macroeconomic and microeconomic approaches, evolution towards a prospective payment system].

In this article we have reviewed the cost of cancer in France, based on a literature review. The cost of the treatment of cancer is estimated to be 10 thousand million euros for 75,000 lives saved annually. The increasing number of economic evaluations of cancer use both a macro economic approach, based on DRG data, and a micro economic approach, based on cost result analysis. These cost studies provide the elements for a decision aid in the context of social demands, budget constraints and the evolution towards a DRG's prospective payment system which characterises present organisation of health care in France.

Cost-Benefit Analysis↗

The basis and relevance of emotional dignity.

The paper is a preliminary examination of the origin and role of psychological perception or "feeling" of dignity in human beings. Following Ayala's naturalistic account of morality, a sense of emotional dignity is seen as an outcome of processes of natural selection, cultural evolution, and above all a need for social inclusion. It is suggested that the existence of emotional dignity as part of a human species-related continuum provides an explanation of why we treat those in a persistent vegetative state, the severely and hopelessly mentally impaired, the senile demented, cadavers and archaeological remains with dignity and respect. For older Europeans, dissonance between physical and mental abilities, unfamiliarity with social and cultural changes and relative proximity to death may influence their emotional dignity and hence vulnerability.

Aged↗

The hitchhiker's guide to altruism: gene-culture coevolution, and the internalization of norms.

An internal norm is a pattern of behavior enforced in part by internal sanctions, such as shame, guilt and loss of self-esteem, as opposed to purely external sanctions, such as material rewards and punishment. The ability to internalize norms is widespread among humans, although in some so-called "sociopaths", this capacity is diminished or lacking. Suppose there is one genetic locus that controls the capacity to internalize norms. This model shows that if an internal norm is fitness enhancing, then for plausible patterns of socialization, the allele for internalization of norms is evolutionarily stable. This framework can be used to model Herbert Simon's (1990) explanation of altruism, showing that altruistic norms can "hitchhike" on the general tendency of internal norms to be personally fitness-enhancing. A multi-level selection, gene-culture coevolution argument then explains why individually fitness-reducing internal norms are likely to be prosocial as opposed to socially harmful.

Altruism↗

"Fair shares": beyond capitalism and socialism, or the biological basis of social justice.

The accumulating scientific evidence -- across many disciplines -- regarding human evolution and the dualities and complexities of human nature indicates that the core ideological assumptions of both capitalism and socialism are simplistic and ultimately irreconcilable. A biologically grounded approach to social justice enables us to articulate a new ideological paradigm that I call ''Fair Shares.'' This paradigm consists of three complementary normative principles. First, goods and services should be distributed to each according to his or her basic needs. Second, surpluses beyond the provisioning of our basic needs should be distributed according to merit. And, third, each of us is obliged in return to contribute to the ''collective survival enterprise'' in accordance with his or her ability. Though none of these three principles is new, in combination they provide a biologically informed middle way between capitalism and socialism. Some of the many issues that are raised by this formulation are also briefly addressed.

Journal Article↗

Primate sociality in evolutionary context.

Much work has been done to further our understanding of the mechanisms that underlie the diversity of primate social organizations, but none has addressed the limits to that diversity or the question of what causes species to either form or not form social networks. The fact that all living primates typically live in social networks makes it highly likely that the last common ancestor of living primates already lived in social networks, and that sociality formed an integral part of the adaptive nature of primate origins. A characterization of primate sociality within the wider mammalian context is therefore essential to further our understanding of the adaptive nature of primate origins. Here we determine correlates of sociality and nonsociality in rodents as a model to infer causes of sociality in primates. We found sociality to be most strongly associated with large-bodied arboreal species that include a significant portion of fruit in their diet. Fruits and other plant products, such as flowers, seeds, and young leaves, are patchily distributed in time and space and are therefore difficult to find. These food resources are, however, predictable and dependable when their location is known. Hence, membership in a social unit can maximize food exploitation if information on feeding sites is shared. Whether sociality evolved in the primate stem lineage or whether it was already present earlier in the evolution of Euarchontoglires remains uncertain, although tentative evidence points to the former scenario. In either case, frugivory is likely to have played an important role in maintaining the presence of a social lifestyle throughout primate evolution.

Animals↗

A cross-national test of propositions from the neo-pluralist perspective on Social Security expenditures.

Much of the existing literature on cross-national differences in retirement wage policy has focused on the inception of programs and the factors leading to their introduction. The explanations may be less adequate in accounting for post-war changes in social security programs. To interpret the evolution of programs in the post-war period, we stress the importance of divisions among workers themselves. We argue here that such divisions may occur along three fault lines: (1) ethnic, racial, and linguistic differentiation (2) the split between heavily urbanized and other segments of the working population and (3) fractionalization brought about by domination of a single industry. Using a longitudinal design to measure changes in social security expenditures in 34 nations between 1965 and 1983, we test hypotheses asserting that fragmentation among workers is inversely correlated with expanded investment in benefits for workers. We find general support for these hypotheses.

Aged↗

[Non-discriminatory treatment of aged patients by dialysis].

The increase in the number of old people treated by dialysis is a result both from the demographic evolution of the industrialized countries and from the changes occurred in the behaviour of physicians, families and the elderly themselves, faced to illness and death. A great number of old people with chronic renal failure are nevertheless kept away from the dialysis, most often under the pretext of doubtful medical contra-indications or because of an insufficient autonomy. The quality of the family environment, along with the social insertion intervene significantly in the evolution of the drawbacks associated to the renal failure and result in being determining criteria in the decision of carrying out or not the treatment. Any selective policy based on the loneliness or the financial situation of the elderly appears particularly unfair. The equipment which we have our disposal nowadays should enable us to treat all these patients, under the condition, however, of developing the program of peritoneal dialysis as well as the different alternatives to the center hemodialysis.

Aged↗

Between welfare medicine and mainstream entitlement: Medicaid at the political crossroads.

As the new century begins, the Medicaid program is arguably at a political crossroads. Over the 1980s and 1990s, policy makers enacted major expansions in Medicaid coverage, offering significant new health benefits to poor women and children and other constituencies. In elite rhetoric and political framing, Medicaid was increasingly cast as a broad-based social welfare entitlement of value to all Americans, including middle-class citizens. Some health care advocates began viewing Medicaid expansions as a potential path to achieving universal coverage in the United States. Yet Medicaid remains a means-tested program that has been repeatedly threatened with policy retrenchment. In this essay, we scrutinize Medicaid's current status and future possibilities from a historical-institutional perspective by tracing its complex evolution since its enactment in the Social Security Amendments of 1965. Our core claim is that decisions made at the time of Medicaid's original adoption have fundamentally set the matrix for struggles over the program's unfolding development. We demonstrate that key ambiguities embedded in the 1965 act created largely unintended opportunities for policy entrepreneurs to broaden Medicaid's scale and scope as well as foreseeable vulnerabilities that must be overcome if Medicaid is to realize its full potential.

Aged↗

The alliance theory of homosexual behavior and the perception of social status and reproductive opportunities.

OBJECTIVES: The alliance theory holds that homosexual behavior in humans may have evolved because it reinforced same-sex alliances which contributed to survival and reproduction. The present study was designed to test this evolutionary hypothesis in view of the strongly negative perception of homosexual behavior. It was predicted that targets who engaged in homosexual behavior would be perceived as likely to achieve greater social status and reproductive opportunities when the behavior reinforced an alliance that led to increased social opportunities. METHODS: Three hundred sixteen men and women read scenarios in which a target engaged in homosexual behavior and then answered questions about the target's future social status and reproductive opportunities as measured by number of sexual partners. The data were analyzed in two 3 (social outcome: positive vs. neutral vs. negative) x 2 (gender of target) x 2 (gender of participant) analyses of variance. RESULTS: The results supported the predictions and demonstrated that targets were perceived as likely to have the greatest social status and reproductive opportunities in the positive outcome condition. CONCLUSION: The alliance theory of homosexual behavior may have heuristic value for the evolutionary study of homosexual behavior and its perception.

Adaptation, Psychological↗

The position of psychiatry in the understanding of human disease.

The article discusses psychiatry and the concept of disease. This is approached by first reviewing generic attributes of the concept and how it has come to be used in contemporary medicine. Psychiatry's time-honored concern with alterations in social behavior is analyzed in the light of the generic attributes of disease. A holistic and adaptational perspective toward disease is discussed, and in particular, how psychiatry stands in relation to such a perspective. Alternative paradigms for ordering behavioral changes that can be implicated in disease are suggested. In adopting such a perspective, and rigorously exploring how disease and behavior interrelate, psychiatry becomes one of the disciplines that examines fundamental questions about man and social adaptation.

Biological Evolution↗

[Chagas-Mazza disease. Preliminary basic social study].

Chagas-Mazza disease is an endemic infection of chronic evolution and is essentially American. Its transmission by vinchuca in Argentine has created a medical, psychological and social problem of great and important significance. The basic, preliminary and social study carried out in a hospital unit, showed in the population attended, precarious socioenvironmental conditions during childhood and adolescence and the almost total lack of basic information on the disease. Interviews, inquests, questionnaires, group actions, team work, direct dialogues, counselling and guidance groups and the guiding to specialized institutions, constitute a synthesis of the task developed which, in its preliminary stage, showed sufficient reasons to continue the control of health during pregnancy, childbirth, puerperium and lactation.

Argentina↗

Emerging themes in the history of medicine.

The critical themes that have emerged in medical history over the last 25 years reflect the development of a "new social history of medicine." The earlier focus on the evolution of medical knowledge has been replaced by work that emphasizes the nature of the social responses to disease, their sociocultural meanings and historical epidemiology. Because medical historiography reflects debates and questions in contemporary medical culture, the AIDS epidemic is likely to have an important impact on the study of medical history in the immediate future.

Acquired Immunodeficiency Syndrome↗

Evolution of intrafamilial interactions.

A theory for the evolution of behavioral interactions among relatives is developed that allows for genetic correlations between the types of behavior that are expressed in different social contexts. Both theoretical and empirical considerations indicate that such genetic constraints will almost certainly be common in natural populations. It is shown that when genetic correlations between elements of social behavior exist, Hamilton's rule inaccurately describes the conditions for evolution by way of kin selection. The direction in which social organization evolves is a delicate function of the genetic covariance structure among behaviors expressed as an offspring, sibling, parent, etc. A change in this covariance structure caused by random genetic drift or by a change in environment for a population exhibiting genotype-environment interaction can cause the population to suddenly cross a threshold into a new selective domain. Consequently, radical changes in social organization may arise between closely related species without any major shift in selective pressures external to the population.

Altruism↗

Self-recognition in an Asian elephant.

Considered an indicator of self-awareness, mirror self-recognition (MSR) has long seemed limited to humans and apes. In both phylogeny and human ontogeny, MSR is thought to correlate with higher forms of empathy and altruistic behavior. Apart from humans and apes, dolphins and elephants are also known for such capacities. After the recent discovery of MSR in dolphins (Tursiops truncatus), elephants thus were the next logical candidate species. We exposed three Asian elephants (Elephas maximus) to a large mirror to investigate their responses. Animals that possess MSR typically progress through four stages of behavior when facing a mirror: (i) social responses, (ii) physical inspection (e.g., looking behind the mirror), (iii) repetitive mirror-testing behavior, and (iv) realization of seeing themselves. Visible marks and invisible sham-marks were applied to the elephants' heads to test whether they would pass the litmus "mark test" for MSR in which an individual spontaneously uses a mirror to touch an otherwise imperceptible mark on its own body. Here, we report a successful MSR elephant study and report striking parallels in the progression of responses to mirrors among apes, dolphins, and elephants. These parallels suggest convergent cognitive evolution most likely related to complex sociality and cooperation.

Animals↗