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PubMedDate not supplied

AIDS and the social sciences: review of useful knowledge and research needs.

This paper reviews several areas of social science research that are relevant to the critical social dimensions of the AIDS crisis. These dimensions include how to effect changes in behavior so as to break the chain of transmission, how best to inform the public about risks so as to develop reasonable and nondiscriminatory policies and practices based on the best available scientific information, and how to organize health care and social services so as to treat persons with AIDS effectively, humanely, and at reasonable cost. Relevant research in the social sciences includes studies of behavioral risk modification, risk perception, communication and persuasion, attitudes toward civil liberties, and the organization of health care. This work suggests useful avenues for research on AIDS that could provide the understanding necessary to develop effective ways of approaching the problems presented by this devastating disease.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Reinterpreting ethnic patterns among white and African American men who inject heroin: a social science of medicine approach.

BACKGROUND: Street-based heroin injectors represent an especially vulnerable population group subject to negative health outcomes and social stigma. Effective clinical treatment and public health intervention for this population requires an understanding of their cultural environment and experiences. Social science theory and methods offer tools to understand the reasons for economic and ethnic disparities that cause individual suffering and stress at the institutional level. METHODS AND FINDINGS: We used a cross-methodological approach that incorporated quantitative, clinical, and ethnographic data collected by two contemporaneous long-term San Francisco studies, one epidemiological and one ethnographic, to explore the impact of ethnicity on street-based heroin-injecting men 45 years of age or older who were self-identified as either African American or white. We triangulated our ethnographic findings by statistically examining 14 relevant epidemiological variables stratified by median age and ethnicity. We observed significant differences in social practices between self-identified African Americans and whites in our ethnographic social network sample with respect to patterns of (1) drug consumption; (2) income generation; (3) social and institutional relationships; and (4) personal health and hygiene. African Americans and whites tended to experience different structural relationships to their shared condition of addiction and poverty. Specifically, this generation of San Francisco injectors grew up as the children of poor rural to urban immigrants in an era (the late 1960s through 1970s) when industrial jobs disappeared and heroin became fashionable. This was also when violent segregated inner city youth gangs proliferated and the federal government initiated its "War on Drugs." African Americans had earlier and more negative contact with law enforcement but maintained long-term ties with their extended families. Most of the whites were expelled from their families when they began engaging in drug-related crime. These historical-structural conditions generated distinct presentations of self. Whites styled themselves as outcasts, defeated by addiction. They professed to be injecting heroin to stave off "dopesickness" rather than to seek pleasure. African Americans, in contrast, cast their physical addiction as an oppositional pursuit of autonomy and pleasure. They considered themselves to be professional outlaws and rejected any appearance of abjection. Many, but not all, of these ethnographic findings were corroborated by our epidemiological data, highlighting the variability of behaviors within ethnic categories. CONCLUSIONS: Bringing quantitative and qualitative methodologies and perspectives into a collaborative dialog among cross-disciplinary researchers highlights the fact that clinical practice must go beyond simple racial or cultural categories. A clinical social science approach provides insights into how sociocultural processes are mediated by historically rooted and institutionally enforced power relations. Recognizing the logical underpinnings of ethnically specific behavioral patterns of street-based injectors is the foundation for cultural competence and for successful clinical relationships. It reduces the risk of suboptimal medical care for an exceptionally vulnerable and challenging patient population. Social science approaches can also help explain larger-scale patterns of health disparities; inform new approaches to structural and institutional-level public health initiatives; and enable clinicians to take more leadership in changing public policies that have negative health consequences.

Abscess↗
PubMedDate not supplied

The resurgence of tuberculosis in the tropics. Improving tuberculosis control--social science inputs.

Public health has for long been dominated by the notion of 'control'. However, social science research on tuberculosis in the tropics indicates that policies and programmes that take 'control' as their primary focus may fail to meet the health needs of patients and their communities. It is proposed that research and programmes meet the public health goal of lowering the prevalence of disease in populations by forging and cementing partnerships which take the support and care of patients as their focus. These will be partnerships between researchers in the North and the South, between research and programmes/policy, between outside 'experts' and communities themselves and between (public) health and other social service sectors. Social science approaches to operations research in tuberculosis are outlined, and data from a recent project in New Delhi are introduced.

Algorithms↗
PubMed1997

Social science and the public agenda: reflections on the relation of knowledge to policy in the United States and abroad.

It is tempting to oversell the practical value of applied research. A hard look at the effects of U.S. social science on public policy in areas such as active labor market policies (training, job creation, placement, etc.), crime prevention, fiscal policy, poverty reduction, and health care reform suggests an inverse relationship between social science consensus and policy and budgetary decisions. Fragmented and decentralized political economies (e.g., the United States) foster policy segmentation and isolated, short-run single-issue research--often politicized and misleading. More corporatist democracies (such as Sweden, Norway, Austria, and Germany) evidence a tighter relation between knowledge and power in which a wider range of issues is connected, longer-range effects are sometimes considered, and research is more often actually used for planning and implementation. Even in less hospitable societies, however, social science does make its way in the long run. Favorable conditions and examples are discussed.

Cross-Cultural Comparison↗
PubMed1998

[The social sciences' other health-care discourse].

Since the late 1960s and early 1970s, concern over inadequate social conditions - which is what has truly hampered human development - has been focused on growth together with equity. If human development is a process which should steadily broaden human options, what place does this concept play in the discourse of the social sciences and politics as 'master' - whose major product today is greater poverty, overpopulation, and less options for people? How can this situation be reverted, so that people can enjoy a long, healthy life, receive an education, and have access to the resources that are needed if their life chances are to be greater than their death chances? What role does or should the social sciences play in devising an ethical discourse on health care? To what objectives will we need to return, if we are to refrain from using scientific knowledge to validate the unjust social inequalities espoused in the discourses of power and of the master?

Delivery of Health Care↗
PubMed2004

The problem of evidence-based medicine: directions for social science.

Evidence-based medicine (EBM) is arguably the most important contemporary initiative committed to reshaping biomedical reason and practice. The move to establish scientific research as a fundamental ground of medical decision making has met with an enthusiastic reception within academic medicine, but has also generated considerable controversy. EBM and the broader forms of evidence-based decision making it has occasioned raise provocative questions about the relation of scientific knowledge to social action across a variety of domains. Social science inquiry about EBM has not yet reached the scale one might expect, given the breadth and significance of the phenomenon. This paper contributes reflections, critique and analysis aimed at helping to build a more robust social science investigation of EBM. The paper begins with a "diagnostics" of the existing social science literature on EBM, emphasizing the possibilities and limitations of its two central organizing analytic perspectives: political economy and humanism. We further explore emerging trends in the literature including a turn to original empirical investigation and the embrace of "newer" theoretical resources such as postmodern critique. We argue for the need to move the social inquiry of EBM beyond concerns about rationalization and the potential erasure of the patient and, to this end, suggest new avenues of exploration. The latter include analysis of clinical epidemiology and clinical reason as the discursive preconditions of EBM, the role of the patient as a site for the production of evidence, and the textually mediated character of EBM.

Evidence-Based Medicine↗
PubMed2003

Our "Collegium Antropologicum" officially the most improved social science journal in the world for mid-2002.

Thomson ISI's bimonthly web-product ISI Essential Science Indicators (ESI) is an in-depth analytical tool that regularly reports quantitative analyses of research performance and science trends, covering about 8,500 scientific journals from the entire world. In each issue ESI lists the scientists, institutions, countries and journals that are most improved from one update to the next, i.e. that show the largest percentage increase in total citations. In its edition of January 2003, it reported that our "Collegium Antropologicum" was the most improved journal in the field of Social Sciences during the period from July 2002 to September 2002. The field of Social Sciences is one of 22 categories of science regularly analyzed by ESI. It includes anthropology, public health, sociology, social work and policy, political science, law, education, communication, library and information sciences, environmental studies and rehabilitation. Due to journal's success, which is based on publications of predominantly Croatian scientists within the past seven post-war years, Croatia was also officially the most improved among more than 200 countries, and University of Zagreb was the most improved in the field of Social Science among thousands of other institutions. We hope that this is an early sign of revival of the scientific activity in our country after the War in Croatia (1991-1995).

Anthropology↗
PubMed1997

Behavioral and social sciences at the Centers for Disease Control and Prevention. Critical disciplines for public health.

The mission of the Centers for Disease Control and Prevention (CDC) is to promote health and quality of life by preventing and controlling disease, injury, and disability. Fifty years ago, CDC's efforts were focused on epidemiologic and laboratory studies of malaria, typhus, and plague. Today, CDC's activities cover a broad range of diseases and conditions, and a broader range of disciplines are required to address these diverse public health problems. The behavioral and social sciences have a critical role to play in helping the public understand risk group characteristics and the frequency, context, and determinants of risky behaviors and in developing, implementing, and assessing prevention programs. CDC is taking steps to foster an environment in which behavioral and social sciences can flourish and to integrate these sciences into all of CDC's prevention activities. Other articles in this section describe the breath and nature of the contributions of behavioral and social sciences at CDC.

Behavioral Sciences↗
PubMed1981

The contribution of social science research to health policy: the Royal Commission on the National Health Service.

This article adopts a case study approach to examine the contribution of social science research to health policy. It concentrates exclusively on the recent Royal Commission on the National Health Service. After describing its background and modus operandi the paper goes on to assess the Report's utilization of social science research, both in its diagnosis and recommendations. This assessment suggests that while the Commissioners made relatively little use of research-based evidence in their diagnosis, their recommendations provide the basis for a substantial increase in the contribution of social scientists, particularly in the field of health services evaluation.

Health Policy↗
PubMed1998

Towards quality of care in child health programmes: a challenge for the partnership in health and social sciences.

Several child health care programmes, though often well conceived, are poorly implemented at field level and focus primarily on quantitative achievements to the neglect of quality of care. This paper presents a quality of care (QOC) framework for child health programmes from the perspectives of the management system of an organization and the provider-client interface at point of service delivery. The paper subsequently describes the application of qualitative and quantitative research tools drawn from the social sciences and health sciences for planning and evaluating quality of care. An integrated and complementary use of these tools is recommended. It is suggested that minimum standards, which are region specific, be articulated for quality maintenance in child health programmes. These standards may be upgraded as quality improves. Finally, the challenges which a partnership of the health and social sciences may have to take up are discussed. These include advocacy for prioritization of QOC in child health programmes, facilitating an environment which supports quality of care, promoting inter-disciplinary action research, training students in social science research in universities and research organizations, documenting success stories.

Child↗
PubMed1981

Medicine as social science: the case of Freud on homosexuality.

This paper considers the question of whether the explanation of homosexual orientation offered by Sigmund Freud qualifies as a genuine explantation, judged by the criteria of the social sciences. It is argued that the explanation, namely that homosexual orientation is a function of atypical parental influences, is indeed an explanation of the kind found in the social sciences. Nevertheless, it is concluded that to date Freud's hypotheses about homosexuality are no more than unproven speculations. Also considered is the question of whether the very topic of homosexuality falls or ought to fall within the domain of medical inquiry.

Classification↗
PubMed2004

Weaving basic and social sciences into a case-based, clinically oriented medical curriculum: one school's approach.

Southern Illinois University School of Medicine recently completed its fourth year of a resource-session-enhanced, case-based, tutor-group-oriented curriculum. As an example of a curricular unit, the authors describe the implementation of the basic and clinical sciences in one of the four units in year one, and detail that unit's organization, logistics, content, rationale, and other characteristics. The Sensorimotor Systems and Behavior (SSB) unit is preceded by a cardio-respiratory-renal unit and is followed by an endocrine-reproductive-gastrointestinal unit. A Doctoring unit temporally spans each of these three units. The SSB unit is allotted an 11.5-week period that includes an aggregate of 2.5 weeks of available clinical time, 1.5 weeks for examinations and exam study time, and approximately 8.5 weeks for tutor-group sessions, mandatory laboratory sessions, and self-directed learning. Optional resource sessions are offered during a two- to four-hour block on a single morning each week. Clinical training in the SSB unit augments self-directed, laboratory, and tutor-group learning of neuroscience, gross anatomy, cell biology, physiology, biochemistry, behavioral and social science, embryology, limited pharmacology and genetics, and basic clinical neurology for first-year students. Although it is fast-paced and places heavy responsibility for independent learning on the students, the SSB unit culminates in significant achievement in the basic and clinical sciences. The unit provides substantial clinical training and practical experience in physical and neurological examinations that directly integrate with basic science knowledge. The unit reduces lecture-based instruction, demands self-determination, and promotes experience in team effort, professionalism, peer interaction, empathy in clinical medicine, and practical use of basic science knowledge.

Curriculum↗
PubMed2001

Ethical boundary work: geneticization, philosophy and the social sciences.

This paper is a response to Henk ten Have's "Genetics and Culture: The Geneticization thesis". In it, I refute Ten Have's suggestion that geneticization is not the sort of process that can be measured and commented on in terms of empirical evidence, even if he is correct in suggesting that it should be seen as part of 'philosophical discourse'. At the end, I relate this discussion to broader debates within bioethics between the social science and philosophy, and suggest the need for philosophical approaches to take the social sciences seriously.

Bioethics↗
PubMed2005

Integrating behavioral and social science research into microbicide clinical trials: challenges and opportunities.

It has been argued that rigid thinking about the types and progression of research needed to evaluate health promotion interventions has stymied the process by which research is translated to action. This argument is particularly salient in the field of HIV/AIDS prevention. We examined microbicide research and identified challenges that obstruct the integration of clinical trial and behavioral and social science research, thereby reinforcing linear programs of research. We found that behavioral and social science research can both support microbicide clinical trial performance and anticipate the information most needed for a rapid and successful introduction of future microbicide products.

Administration, Topical↗
PubMed2002

Blood, politics, and social science. Richard Titmuss and the Institute of Economic Affairs, 1957-1973.

Long before his last book, The Gift Relationship: From Human Blood to Social Policy, was published in early 1971, Richard M. Titmuss (1907-1973), a professor of social administration at the London School of Economics, had been a major figure in the debates over the welfare state. The Gift Relationship was the culmination of an eventful relationship with the Institute of Economic Affairs, a think tank that advocated the extension of rational pricing to social services. By arguing that the British system of blood procurement and distribution, based on free giving within the National Health Service, was more efficient than the partly commercialized American system, Titmuss intended to signal the dangers of the increasing commercialization of society. What made for the impact of his book, however, was not merely its argument that transfusion-transmitted infections were much more common with paid than with voluntary donors, but also its reflections on what it is that holds a society together. And here Titmuss argued that a "socialist" social policy, by encouraging the sense of community, played a central role. The eclecticism of Titmuss's work, together with its strong ethical and political flavor, makes it a rich and original account of the "social" at a time when heated debated over social policy, both in Britain and in the United States, raised the question of the division of labor among the social sciences.

Altruism↗
PubMed2002

Social sciences in malaria control.

The second annual meeting of the Partnership for Social Sciences in Malaria Control was held at the London School of Hygiene and Tropical Medicine, UK, from 8 to 10 January 2002.

Animals↗