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PubMed2005

The privileging of communitarian ideas: citation practices and the translation of social capital into public health research.

The growing use of social science constructs in public health invites reflection on how public health researchers translate, that is, appropriate and reshape, constructs from the social sciences. To assess how 1 recently popular construct has been translated into public health research, we conducted a citation network and content analysis of public health articles on the topic of social capital. The analyses document empirically how public health researchers have privileged communitarian definitions of social capital and marginalized network definitions in their citation practices. Such practices limit the way public health researchers measure social capital's effects on health. The application of social science constructs requires that public health scholars be sensitive to how their own citation habits shape research and knowledge.

Health Services Research↗
PubMed2001

Are qualitative methods misunderstood?

Qualitative research methods are increasingly utilised by health researchers. Along with this the criteria for assessing the quality of qualitative research are changing from a natural science model to an interpretative social science model. This is a product of the realisation by health researchers that qualitative methods utilise a different epistemology to statistical methods. I demonstrate that a recent article in the Australian and New Zealand Journal of Public Health draws on a now outdated natural science methodology of assessing bias in focus groups. Drawing on interpretativist social science theory and recent work in the British Medical Joumal I argue for the importance of examining the social contexts through which qualitative data is produced.

Anecdotes as Topic↗
PubMed2001

Evaluating informatics applications--some alternative approaches: theory, social interactionism, and call for methodological pluralism.

A review of evaluation literature concerning CDSSs indicates that randomized controlled clinical trials (RCTs) are the 'gold standard' for evaluation. While this approach is excellent for studying system or clinical performance, it is not well suited to answering questions concerning whether systems will be used or how they will be used. Because lack of use of CDSS has been of concern for some years, other evaluation research designs are needed to address those issues. This paper critiques RCT and experimental evaluation approaches and presents alternative approaches to evaluation that address questions outside the scope of the usual RCT and experimental designs. A wide range of literature is summarized to illustrate the value of evaluations that take into account social, organizational, professional, and other contextual considerations. Many of these studies go beyond the usual measures of systems performance or physicians' behavior by focusing on 'fit' of the system with other aspects of professional and organizational life. Because there is little explicit theory that informs many evaluations, the paper then reviews CDSS evaluations informed by social science theories. Lastly, it proposes a theoretical social science base of social interactionism. An example of such an approach is given. It involves a CDSS in psychiatry and is based on Kaplan's 4Cs, which focus on communication, control, care, and context. Although the example is a CDSS, the evaluation approach also is useful for clinical guideline implementation and other medical informatics applications. Similarly, although the discussion is about social interactionism, the more important point is the need to broaden evaluation through a variety of methods and approaches that investigate social, cultural, organizational, cognitive, and other contextual concerns. Methodological pluralism and a variety of research questions can increase understanding of many influences concerning informatics applications development and deployment.

Attitude↗
PubMed1987

[New paradigms in human sciences].

In this paper, the author describes the jump of paradigm in Human Sciences the conceptual model introduced by G. Bateson implies inasmuch as it shifts emphasis from the analysis of facts to formal organization of reality, and defines 'mental' as a concept which comprehends an organism with relation to its surroundings. The author reviews the main ideas Bateson extracted from both the systems theory and cybernetics in order to outline his 'ecology of human mind'. The complexity of psychosocial processes, however, requires no such mechanical models--i.e. 'less mechanical' ones--to explain time as a continuum in which changes in human systems occur, for instance. Thus, systems dynamics and recursivity models including a multiplicity of feedback loops contribute with some useful constructs. Finally, some ideas developed within 'hard sciences', applied to Social Sciences to integrate the complexity of the goals are also discussed.

Humans↗
PubMed1998

Effect of undergraduate college major on performance in medical school.

PURPOSE: To determine whether choice of college major has any effect on performance in medical school. METHOD: The author analyzed data for 406 students enrolled in a combined baccalaureate-MD program at Brown University School of Medicine who had matriculated in medical school from 1989 to 1997, determining their undergraduate majors and their medical education performances (as measured by course grades, USMLE, scores and residency program evaluation). RESULTS: Slightly over half of the students had majored in science or mathematics, about a third had majored in the humanities or social sciences, and about a tenth had had double majors or had been independent concentrators. The author found no statistically significant difference between the medical school performances of students who had majored in the sciences or mathematics and those who had majored in the humanities or the social sciences. CONCLUSION: Although preselection bias may influence medical school performance, this study affirms previous findings that choice of undergraduate major has little, if any, statistically significant effect.

Education, Medical↗
PubMed1984

Cross-disciplinary perspectives on a liberal education for physicians.

From an interdisciplinary perspective, this paper has explored the role of the humanities, social sciences, and natural and physical sciences in the preparation of physicians. To become an effective practitioner, a student must acquire both conceptual (theoretical) and sensuous (experiential) knowledge. The humanities provide the student with a uniquely rich opportunity to gain sensuous knowledge. The social sciences assist the medical student to gain conceptual and experiential knowledge, especially in the realm of understanding the self and in identifying similarities and differences between individuals, groups, and entire communities. The natural and physical sciences assist the student of the medical sciences in developing the conceptual knowledge needed to understand how the human body works and what causes disease. Beyond that, however, the sciences can help a medical student to develop reasoning power, sharpen problem-solving abilities, and realize how scientific knowledge influences his/her own personal world view. Finally, the sciences provide the conceptual and methodological tools that enable a medical student to serve others.

Curriculum↗
PubMed1991

Science and social policy problems: resolution of some, creation of others.

The scientist has two jobs: to do good science, and to be a spokesperson for science in the creation of rational social policy. Three categories of interaction between science and policy are described and examples given. The first is where science has provided data that were decisive in causing policy to be enacted. The second is where science is capable of resolving equity issues that have arisen from problems that science itself created. The third is where the issues are ultimately resolved by extra-scientific considerations. Two major issues where it is hoped that science can make a significant contribution include outcomes analysis, a new approach to dealing with health care costs and variations in clinical practice; and the disease concept of alcoholism, with questions it raises of volition, personal responsibility, and punishment. However, science alone is never the dominant force in the shaping of policy, which is determined by the interaction of many social forces, such as morals, values, politics, and economics.

Adult↗
PubMedDate not supplied

The structure of medical informatics journal literature.

OBJECTIVE: Medical informatics is an emergent interdisciplinary field described as drawing upon and contributing to both the health sciences and information sciences. The authors elucidate the disciplinary nature and internal structure of the field. DESIGN: To better understand the field's disciplinary nature, the authors examine the intercitation relationships of its journal literature. To determine its internal structure, they examined its journal cocitation patterns. MEASUREMENTS: The authors used data from the Science Citation Index (SCI) and Social Science Citation Index (SSCI) to perform intercitation studies among productive journal titles, and software routines from SPSS to perform multivariate data analyses on cocitation data for proposed core journals. RESULTS: Intercitation network analysis suggests that a core literature exists, one mark of a separate discipline. Multivariate analyses of cocitation data suggest that major focus areas within the field include biomedical engineering, biomedical computing, decision support, and education. The interpretable dimensions of multidimensional scaling maps differed for the SCI and SSCI data sets. Strong links to information science literature were not found. CONCLUSION: The authors saw indications of a core literature and of several major research fronts. The field appears to be viewed differently by authors writing in journals indexed by SCI from those writing in journals indexed by SSCI, with more emphasis placed on computers and engineering versus decision making by the former and more emphasis on theory versus application (clinical practice) by the latter.

Abstracting and Indexing↗
PubMed1990

The legacy of stress research. The course and the impact of this journal.

The Journal of Health and Social Behavior (JHSB) is examined to determine its relative stature and impact in the social science community. We conducted both empirical comparisons of average impact (based on the Social Science Citation Index) and content analysis. Over an 11-year period beginning in 1977, JHSB has maintained an enviable position among sociology journals, ranking significantly higher than the American Journal of Sociology and Social Forces. In addition, it ranks quite favorably when compared with the dominant journals of the allied social science disciplines. The preeminence of the JHSB is attributed to the legacy of stress research that was perceived to dominate this period. Ironically, the recently mandated change in editorial goals eschewing such an identification with stress research has begun to undermine the overall stature of the journal, primarily by reducing the impact of articles on stress that appear in it. We discuss the mechanisms that have influenced the course and the impact of this journal.

Evaluation Studies as Topic↗
PubMed2000

The ethics of clinical research and the conduct of clinical drug trials: international comparisons and codes of conduct.

Human research must respect most rigorous ethical standards to protect both the investigators and subjects. Codes of ethical practice relevant to such research are subjected to reviews around the world including The European Union (EU), the Canadian Tri-Council Policy Statement (including the Medical Research Council, the Natural Sciences and Engineering Research Council and the Social Sciences and Humanities Research Council), the Finnish Parliament Research Act (April 1999) and the National Statement on Ethical Conduct in Research Involving Humans in accordance with the NHMRC Act 1992 (Cth) from the National Health and Medical Research Council of Australia. The Australian Statement was endorsed by the Australian Vice-Chancellors' Committee, the Australian Research Council, the Australian Academy of the Humanities, the Australian Academy of Science and the Academy of Social Sciences in Australia and supported by the Academy of Technological Sciences and Engineering. This reflects the extensive ramifications of human experimentation and the range of stack holders. Private organisations have also produced interpretations of minimum standards of good clinical practice. The paper that follows analyses approaches to human experimentation and the minimal ethical expectations in the conduct of such research.

Australia↗
PubMed1987

[The processes of work and health/disease: a dialectic relationship].

The premise of the authors is that social sciences allow a vision of man as a whole, without separating the biological, psychological and social aspects. In the historical dimension, individuals do not act as isolated entities, but rather as social groups; and it is only from this standpoint that behaviour, events and institutions may be fully understood. The role played by man as a social being is determined by the culture in which he is born and matures as an adult. To understand the health-disease process, it is necessary to go beyond the purely biological approach, where the individual becomes sick basically because of organic disorders, and to look at health problems from the standpoint of the social sciences, which are based theoretically on a broader conception of the individual, allowing an examination of his historical, emotional, and social make-up. The health-disease process is affected by different phenomena whose frequency and intensity vary with time and space; according to the individual level, social class or population group; and economic and social factors. From the relationship between biological, and psychological and social forces, different trends emerge. Some are ecological; others conclude that disease is a social phenomenon in its essence, and biological in its form. This article links the health-disease phenomenon with the labor process and thus places it in the context of occupational health, a field where the social sciences have made their mark. The authors later analyze this process. It is necessary to know all its characteristics, modalities and manifestations, and to discover the final connection between the occupation and the individual, as the only way to have a deeper understanding of the relationship between the labor and health-disease processes.

Disease↗
PubMed1983

Informed consent and patient decision making: two decades of research.

Patient consent to medical treatment has been a subject of concern within the United States professional communities for over two decades. This paper traces the development of research literature on patient decision making and informed consent to medical treatment in three fields of research: medicine, law and the social sciences. A general model for stages in the development of scientific specialties is applied as a test for the development of informed consent as a specialty interest in each research field. Results indicate a relatively advanced stage of development within medicine and law. Research in the social science disciplines tend to lag behind in terms of cumulative number of publications. In addition, social science research which is potentially relevant to the ethical and policy issues of consent in medical treatment appears to lack a clear programmatic thrust, with little attention given to the policy implications of the work. In contrast, the medical and legal literatures indicate a direct concern with social policy and reflect attempts on the part of physicians and lawyers to influence the policy making process.

Behavioral Research↗
PubMed1984

Project community diagnosis: participatory research as a first step toward community involvement in primary health care.

'Community participation' and 'bottom up planning' have become fashionable themes in international health circles. However, in the absence of sociocultural perspective these themes remain largely rhetoric. In this paper, a deprofessionalization of social science is advocated in the service of participatory research as a first step towards community involvement in primary health care. Deprofessionalization is suggested as an adjunct to, not a replacement for in-depth professional social science research. An exploratory community diagnosis of health project conducted in rural south India is described. During the project, lay researchers received rudimentary social science field training and collected data on health behaviour deemed important to health planners as well as the health concerns of the community. Illustrative data, generated by the project is presented on the rural poors' utilization of government health facilities, their attitudes towards Primary Health Centre staff, and their ideas about how a proposed community health worker scheme could best serve them.

Community Health Workers↗
PubMed2003

A half century of longitudinal methods in social gerontology: evidence of change in the journal.

OBJECTIVES: With a focus on the use of longitudinal data, this study reviews trends in the quantitative analysis of social science data on aging during the past half century. METHODS: A content analysis was performed on 227 articles from 12 volumes that were systematically sampled from the Journal of Gerontology: Social Sciences to examine change in the type of data and quantitative methods used (1946-2000). RESULTS: Cross-sectional analysis remains the single most frequent type of study, but the publication of analyses based on longitudinal panel data increased appreciably over the five decades studied. There was little increase in the use of repeated cross-sectional analysis. DISCUSSION: Despite the widespread use of cross-sectional analysis, interest in data with more than one occasion of measurement has grown among social scientists who are reviewing for and publishing in the JOURNAL. Given the longitudinal data now available, social science research on aging should give more explicit attention to three issues: attrition, change in repeated measures of independent variables, and models to account for many waves of data.

Bibliometrics↗
PubMed2002

Attitudes of Hungarian students and nurses to physician assisted suicide.

In Hungary, which has one of the highest rates of suicide in the world, physician assisted suicide (PAS) and euthanasia are punishable criminal acts. Attitudes towards self destruction and assisted suicide are, however, very controversial. We investigated the attitudes of medical students, nurses and social science students in Hungary towards PAS, using a twelve item scale: the total number of participants was 242. Our results indicate a particular and controversial relationship between attitudes towards assisted suicide in Hungary and experience with terminally ill people. The social science students, who had the fewest personal experiences with terminally ill patients, are characterised by the most permissive attitudes towards assisted suicide. Nurses, who had everyday contact and experience with these patients, were the most conservative, being least supportive of assisted suicide. The attitudes of medical students, the would be physicians, are somewhere between those of nurses and social science students.

Adult↗