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PubMed2005

Anthropological insights into the use of race/ethnicity to explore genetic contributions to disparities in health.

Anthropological insights into the use of race/ethnicity to explore genetic contributions to disparities in health were developed using in-depth qualitative interviews with editorial staff from nineteen genetics journals, focusing on the methodological and conceptual mechanisms required to make race/ethnicity a genetic variable. As such, these analyses explore how and why race/ethnicity comes to be used in the context of genetic research, set against the background of continuing critiques from anthropology and related human sciences that focus on the social construction, structural correlates and limited genetic validity of racial/ethnic categories. The analyses demonstrate how these critiques have failed to engage geneticists, and how geneticists use a range of essentially cultural devices to protect and separate their use of race/ethnicity as a genetic construct from its use as a societal and social science resource. Given its multidisciplinary, biosocial nature and the cultural gaze of its ethnographic methodologies, anthropology is well placed to explore the cultural separation of science and society, and of natural and social science disciplines. Anthropological insights into the use of race/ethnicity to explore disparities in health suggest that moving beyond genetic explanations of innate difference might benefit from a more even-handed critique of how both the natural and social sciences tend to essentialize selective elements of race/ethnicity. Drawing on the example of HIV/AIDS, this paper demonstrates how public health has been undermined by the use of race/ethnicity as an analytical variable, both as a cipher for innate genetic differences in susceptibility and response to treatment, and in its use to identify 'core groups' at greater risk of becoming infected and infecting others. Clearly, a tendency for biological reductionism can place many biomedical issues beyond the scope of public health interventions, while socio-cultural essentialization has tended to stigmatize 'unhealthy behaviours' and the communities where these are more prevalent.

Anthropology, Cultural↗
PubMedDate not supplied

[Encounters and disencounters between qualitative and quantitative perspective in History of Medicine].

The presentation of qualitative research methods in the health care field underlines how these methods are irrelevant to and inconsistent with scientific traditions in the Health Sciences field. These methods are to of a quantitative nature--epidemiology usually being cited as an example--the connection between but qualitative methods and what are referred to as the Social Sciences seems predominant. This article is aimed, on the contrary, at pointing out that qualitative methodologies, which are richer and more highly complex that the quantitative approach, do comprise an intrinsic part of Health Science traditions. A run through the major milestones and events throughout the history of Medicine reveals the paradoxical protocol of Health Sciences, overlapping the Natural Sciences and Social Sciences, overlapping qualitative and the quantitative view. More specifically, this analysis revolves around a twofold approach to illness, by way of signs and symptoms, as a condensing these paradoxical protocol considered. A historical analysis reveals how the twofold, complex way of signs and symptoms is equivalent to the complex relationship which exists between the qualitative and the quantitative perspective. The signs correspond to quantitative approach and the symptoms to the more qualitative. The relationships between the two would be similar to that existing come to bear between the qualitative and quantitative perspectives in the field of the Social Sciences. These results show the qualitative perspective to be rooted in medical tradition itself and may therefore facilitate its use these by all health care professionals as a whole. The fact that the "semiology" so in vogue today in the social sciences stems from "clinical semiology" should not be overlooked.

Clinical Medicine↗
PubMedDate not supplied

Communication and teamwork in patient care: how much can we learn from aviation?

OBJECTIVE: To identify evidence on the role of assertiveness and teamwork and the application of aviation industry techniques to improve patient safety for inpatient obstetric care. DATA SOURCES: Studies limited to research with humans in English language retrieved from CINAHL, PubMed, Social Science Abstracts, and Social Sciences Citation Index, and references from reviewed articles. STUDY SELECTION: A total of 13 studies were reviewed, including 5 studies of teamwork, communication, and safety attitudes in aviation; 2 studies comparing these factors in aviation and health care; and 6 studies of assertive behavior and decision making by nurses. Studies lacking methodological rigor or focusing on medication errors and deviant behavior were excluded. DATA SYNTHESIS: Pilot attitudes regarding interpersonal interaction on the flight deck predicted effective performance and were amenable to behavior-based training to improve team performance. Nursing knowledge was inconsistently accessed in decision making. Findings regarding nurse assertiveness were mixed. CONCLUSIONS: Adaptation of training concepts and safety methods from other fields will have limited impact on perinatal safety without an examination of the contextual experiences of nurses and other health care providers in working to prevent patient harm.

Accidents, Aviation↗
PubMedDate not supplied

The travesty of choosing after positive prenatal diagnosis.

OBJECTIVE: To integrate the findings of qualitative studies of expectant parents receiving positive prenatal diagnosis. DATA SOURCES: Seventeen published and unpublished reports appearing between 1984 and 2001 and retrieved between December of 2002 and March of 2003. The electronic databases searched include Academic Search Elite, AIDS Information Online (AIDSLINE), Anthropological Index Online, Anthropological Literature, Black Studies, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Digital Dissertations, Dissertation Abstracts Index (DAI), Educational Resource Information Center (ERIC), MEDLINE, PsycInfo, Public Affairs Information Service (PAIS), PubMed, Social Science Abstracts (SocSci Abstracts), Social Science Citation Index, Social Work Abstracts, Sociological Abstracts (Sociofile), Women's Resources International, and Women's Studies. STUDY SELECTION: Qualitative studies involving expectant parents living in the United States of any race, ethnicity, nationality, or class who learned during any time in pregnancy of any fetal impairment by any means of diagnosis were eligible for inclusion. DATA EXTRACTION: Metasummary techniques, including the calculation of frequency effect sizes, were used to aggregate the findings. Metasynthesis techniques, including constant comparison analysis and the reciprocal translation of concepts, were used to interpret the findings. DATA SYNTHESIS: The topical emphasis in the findings is on the termination of pregnancy following positive diagnosis. The thematic emphasis is on the dilemmas of choice and decision making. Positive prenatal diagnosis was for couples an experience of chosen losses and lost choices. Couples managed information to minimize stigmatization and cognitive dissonance. CONCLUSIONS: Existing guidelines for caring for couples after perinatal losses must accommodate the chosen loss experientially defining positive prenatal diagnosis.

Abortion, Induced↗
PubMed1975

[Social research as applied to health].

The concepts that have influenced relations between the social sciences and health down the years are broadly analyzed. Various approaches to integration of the social sciences with medicine are described, including social sciences as the study of culture, social medicine, and medicine as a social science. In conclusion, it is suggested that the search for an alternative to the functional approach to health problems should begin with a redefinition of the aims of medicine. Some attempts along these lines are reviewed.

Mexico↗
PubMed2003

Ethics of research involving humans: uniform processes for disparate categories?

The Australian Health Ethics Committee's National Statement on Ethical Conduct in Research Involving Humans (1999) expanded the health and medical focus of preceding statements by including all disciplines of research. The Statement purports to promote a uniformly high ethical standard for this expanded range of research, and is endorsed by, inter alia, the Australian Academy of the Humanities, the Australian Academy of Science, and the Academy of Social Sciences in Australia. High ethical standards should apply to all research involving humans. However, uniformity in the review processes of disparate research endeavors is not a necessary condition for uniformly high ethical standards. Bringing the ethical review of all research under a model which has developed within the context of health and medical research ethics for over thirty years may be inappropriate and at times incoherent. The language, methods, nature and products of research in areas such as the Humanities are often very different from those of health, medical and other sciences. The Behavioral and Social Sciences Ethics Review Committee at The University of Queensland (UQ) had, since the mid-1980s, considered that the guidelines of the time did, in fact, cover all aspects of human experimentation. We describe the ways in which this position was implemented, how issues raised by the new wording in the National Statement have been recently managed by UQ's research ethics committees, and point to outstanding questions.

Advisory Committees↗
PubMedDate not supplied

[Psychiatric science and social service policy: the creation of the University of Brazil's Institute of Psychiatry].

The article analyzes the relations between psychiatric science and social services in Rio de Janeiro from the late 1930s to mid-1950s. The historical development of psychiatric science and social services in France and Germany, each country with its own distinct features, serves as an analytical reference in investigating the Brazilian context, starting with the emergence of psychiatry in Brazil in 1852, when the Hospício Pedro II was founded. In 1938, this asylum was transformed into the University of Brazil's Institute of Psychiatry, bringing the model of German research institutes up to date and reflecting a new correlation of forces between the provision of social services and the production of a Brazilian psychiatric science. At the close of the 1930s, social services and psychiatric science in Rio de Janeiro were taking separate paths: social services still pivoted primarily around asylums while the institutionally, autonomous science of psychiatry focused on the research of mental diseases as manifestations of organic illness.

Brazil↗
PubMed2004

Riding natural scientists' coattails onto the endless frontier: the SSRC and the quest for scientific legitimacy.

This article proposes that the postwar National Science Foundation (NSF) debate constituted a critical, transitional episode in American social science and partisan politics. I show that by responding to powerful conservative critics in the scientific and political communities, the Social Science Research Council's (SSRC's) leading scholars (re)asserted a contested scientistic strategy-to advance the social sciences by following the natural sciences. Further, I reconstruct a wider and longer framework of analysis in order to recover central challenges to the scientistic strategy raised by prominent liberal scholars who rejected the associated commitments to value neutrality and disinterested professionalism. In developing this framework for understanding the contrasting fortunes of each strategy, this article argues that the NSF debate has a deep historical significance-for the social sciences, for American liberalism, and for the nation.

Foundations↗
PubMed1996

Critical social theory as a grounded process.

This article reflects upon the research process that uses critical social science as its basis. Some of the common criticisms of critical social science research are rebutted by following the research trail taken by the authors when undertaking their own projects. The similarities and differences of critical social science and the interpretative methodologies are outlined in the selection of study area, the relationship of the researcher and participants, ethical issues, and data collection and analysis. The writers conclude that critical social science research reports that are correctly carried out should be firmly grounded in each of these stages, thereby a foundation for nursing and midwifery practice.

Data Collection↗
PubMed2001

The success of science and social norms.

In this paper I characterize science in terms of both invisible hand social organization and selection. These two processes are responsible for different features of science. Individuals working in isolation cannot produce much in the way of the warranted knowledge. Individual biases severely limit how much secure knowledge an individual can generate on his or her own. Individuals working in consort are required, but social groups can be organized in many different ways. The key feature of the social organization in science is that only working scientists can confer the most important reward in science--use--and scientists must use each other's work in order to succeed in realizing this goal. An analysis of science as a selection process serves quite a different function. Individual scientists strive to come up with novel solutions to significant problems. The question then becomes how to be creative. From a selective perspective, science as a process involves the production of numerous alternatives and a selection among them. A single scientist solving an important problem makes science look very efficient. Treating science as a selection process casts it in a very different light. In this paper I combine an invisible hand mechanism with a selective perspective in order to explain why science is as successful as it is. I do not make recourse to evolutionary epistemology in any of its traditional senses.

Biological Evolution↗
PubMed1994

What is it precisely that interpretive social research researches?

The literature on interpretive/qualitative social science is maddeningly imprecise with respect to both the focus and aims of interpretive social science; this paper articulates an attempt to address these twin limitations. The dimensions of physical and social reality are compared and the definition of 'meaning' and its acquisitive processes are explored. It is argued that the focus of interpretive social science is the propositions that operate to create and sustain social realities and that the aims of interpretive social science are to construct, in the minds of observing interpretivists, valid mirror images of such propositions, prior to making them public. It is further argued that this can only be achieved by inferring the prior intentional inferences of the human agents being observed. Related methodological implications are discussed as they arise in the analysis.

Cognition↗
PubMed2003

Just because you're imaging the brain doesn't mean you can stop using your head: a primer and set of first principles.

Developments within the neurosciences, cognitive sciences, and social sciences have contributed to the emergence of social neuroscience. Among the most obvious contemporary developments are brain-imaging procedures such as functional magnetic resonance imaging. The authors outline a set of first principles designed to help make sense of brain-imaging research within the fields of cognitive and social neuroscience. They begin with a principle few would debate--that social cognition, emotion, and behavior involve the brain--but whose implications might not be entirely obvious to those new to the field. The authors conclude that (a). complex aspects of the mind and behavior will benefit from yet a broader collaboration of neuroscientists, cognitive scientists, and social scientists, and (b). social psychologists bring important theoretical, methodological, and statistical expertise to this interdisciplinary enterprise.

Affect↗
PubMed2006

Digit ratio and faculty membership: implications for the relationship between prenatal testosterone and academia.

Digit ratio (length of index finger divided by length of ring finger) is an index of exposure to prenatal testosterone. Prenatal testosterone slows the growth rate of the left side of the brain while enhancing growth of the right side. Right hemisphere processing is associated with better visual-spatial and mathematical abilities, as is digit ratio. Thus, traditional sex differences in visual-spatial and mathematical abilities can be attributed to differences in exposure to prenatal testosterone, indexed by a sex dimorphic pattern in digit ratio (female=1.00, male=0.98 for UK samples). Additionally, the digit ratio is a marker for within-sex variance in visual-spatial ability. This study examines the digit ratio of an academic sample. No sex differences are found and there is a significant difference between the Science Faculty and Social Science Faculty. Social Scientists of both sexes have a ratio consistent with the male norm (0.98) whilst Scientists have a digit ratio consistent with the female norm (1.00). These results are discussed in terms of the lower normal range of male testosterone being associated with highest visual spatial abilities. Relationships with fertility and Dyslexia are also identified.

Adult↗
PubMed2004

A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made?

In 1996, Social Science & Medicine published a review of treatment seeking for malaria (McCombie, 1996). Since that time, a significant amount of socio-behavioral research on the home management of malaria has been undertaken. In addition, recent initiatives such as Roll Back Malaria have emphasized the importance of social science inputs to malaria research and control. However, there has been a growing feeling that the potential contributions that social science could and should be making to malaria research and control have yet to be fully realized. To address these issues, this paper critically reviews and synthesizes the literature (published, unpublished and technical reports) pertaining to the home management of illness episodes of malaria in sub-Saharan Africa from 1996 to the end of 2000, and draws conclusions about the use of social science in malaria research and control. The results suggest that while we have amassed increasing quantities of descriptive data on treatment seeking behavior, we still have little understanding of the rationale of drug use from the patient perspective and, perhaps more importantly, barely any information on the rationale of provider behaviors. However, the results underline the dynamic and iterative nature of treatment seeking with multiple sources of care frequently being employed during a single illness episode; and highlight the importance in decision making of gender, socio-economic and cultural position of individuals within households and communities. Furthermore, the impact of political, structural and environmental factors on treatment seeking behaviors is starting to be recognised. Programs to address these issues may be beyond single sector (malaria control programme) interventions, but social science practice in malaria control needs to reflect a realistic appraisal of the complexities that govern human behavior and include critical appraisal and proposals for practical action. Major concerns arising from the review were the lack of evidence of 'social scientist' involvement (particularly few from endemic countries) in much of the published research; and concerns with methodological rigor. To increase the effective use of social science, we should focus on a new orientation for field research (including increased methodological rigor), address the gaps in research knowledge, strengthen the relationship between research, policy and practice; and concentrate on capacity strengthening and advocacy.

Africa South of the Sahara↗
PubMed2001

[Nurturing young surgeons in a competitive society].

Creating and maintaining harmony between natural science and social science is very important for the establishment of a truly rich society in the 21st century. Young surgeons must acquire deep knowledge and excellent techniques, in addition to contributing to social development and human happiness. This paper outlines my personal views of what young surgeons need to do to succeed at all levels in the current competitive society.

Attitude of Health Personnel↗
PubMedDate not supplied

Different wor(l)ds: three approaches to health research.

This article describes three approaches to research in the social sciences: positivist, interpretivist and critical social science. It uncovers some of the philosophical assumptions these approaches adhere to and situates the discussion in the population health arena with respect to these assumptions. The issues under debate are as yet unsolved (and perhaps unsolvable), with long histories in philosophy and sophisticated rationales on all sides. The article advocates defining the underlying terms of discussion and making assumptions explicit to facilitate dialogue, and also encourages exploration of and tolerance for other approaches.

Canada↗