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The key scientific issue of the next century: the science of addiction.

The problem of addiction is believed to be the most important scientific issue of the next century. The solution to the riddle of pharmacologic, psychological, and social addiction to nicotine, heroin, alcohol, and a high-fat diet, and the discovery and implementation of strategies for spreading healthy "addictions" will aid in solving many major public health and social science problems in the next century. All-out efforts should be expended on the comprehensive development of a science of addiction and to the wide-scale effective application of the results of such research in order to promote health, prosperity, and peace for every community in the world.

Forecasting↗

Teaching research to nurses: issues for tutor training.

Research is unknown territory, in too many ways, for many nurses and nurse tutors. It is seen as the province of an elite, using obscure language and esoteric skills with no obvious connection with the world of nursing; in particular, it involves statistics. Pressure for nursing to become a research-based profession can make the fear worse; the gap between research and practice generates blame and guilt in addition to fear. It is not surprising that learning and teaching about research can be very difficult for nurses. This article explores sources of bad feelings about research and suggests ways forward in the training of nurse and midwifery tutors, considering course planning and teaching methods, and peer support in and out of the classroom. It also argues for expanding the range of nursing research used to teach about research, incorporating more qualitative methods and drawing more fully on the social science traditions.

Curriculum↗

Place, policy and practitioners: on rehabilitation, independence and the therapeutic landscape in the changing geography of care provision to older people in the UK.

A growing body of literature in geography and other social sciences considers the role of place in the provision of healthcare with particular interests emerging around the role of the psychological, social and cultural aspects of place in care provision. As healthcare stretches increasingly beyond the traditional four walls of the hospital, so questions of the role of place in practices of care become ever more pertinent. In this paper, we examine the relationship between place and practice in the care and rehabilitation of older people across a range of settings, using qualitative material obtained from interviews and focus groups with nursing, care and rehabilitation staff working in hospitals, clients' homes and other sites in England. By analysing their testimony on the characteristics of different settings, the aspects of place which facilitate or inhibit rehabilitation and the ways in which place mediates and is mediated by social interaction, we consider how various dimensions of place relate to the power-inscribed relationships between service users, informal carers and professionals as they negotiate the goals of the rehabilitation process. We seek to demonstrate how the physical, psychological and social meanings of place and the social processes engendered by the rehabilitation encounter interact to produce landscapes that are more or less therapeutic, considering in particular the structuring role of state policy and formal healthcare provision in this dynamic.

Aged↗

Shared representations between self and other: a social cognitive neuroscience view.

The abilities to identify with others and to distinguish between self and other play a pivotal role in intersubjective transactions. Here, we marshall evidence from developmental science, social psychology and neuroscience (including clinical neuropsychology) that support the view of a common representation network (both at the computational and neural levels) between self and other. However, sharedness does not mean identicality, otherwise representations of self and others would completely overlap, and lead to confusion. We argue that self-awareness and agency are integral components for navigating within these shared representations. We suggest that within this shared neural network the inferior parietal cortex and the prefrontal cortex in the right hemisphere play a special role in interpersonal awareness.

Journal Article↗

Mental representation of social relationships: dimensions, laws, or categories?

The study of social relationships lies at the heart of the social sciences, but psychologists' understanding of the cognitive structures that support them remains in the hinterlands. Two studies supported the proposal that social relationships are represented by a small number of implicit categorical forms in contrast with accounts proposing dimensional representations or formally specifiable laws. Discrete forms based on 2 of Alan Fiske's (1991, 1992) relational models predicted prototypicality ratings defined over a comprehensive field of hypothetical relationships better than corresponding dimensions of communality and authority and 3 laws of complementarity and symmetry propounded by D. J. Kiesler (1983), J. S. Wiggins (1979), and G. Bateson (1979). In addition, "competition" between the orthogonal dimensions was observed, strengthening the argument for categoriality.

Adult↗

The effects of social category norms and stereotypes on explanations for intergroup differences.

A 2-stage model of the construction of explanations for differences between groups is presented. Category norms affect which of 2 groups becomes "the effect to be explained," and stereotypes shape attributions about that group. In 3 experiments, 288 participants wrote explanations for differences between gay and straight men. Explanations focused on gay men who were also judged to have more mutable attributes. However, these effects were not correlated. Participants focused explanations on straight men when explicitly instructed to do so (Experiment 1). Explanations focused on both groups equally when the gay men constituted the numerically larger sample, when gay men were more typical of the overarching category (i.e., people with AIDS) than straight men, or when more straight men were described as performing the behavior (Experiment 2). Stereotype-consistent information prompted more essentialist references and fewer reconstructive references to gay men than did stereotype-inconsistent information (Experiment 3). The relevance of this model for theories of norms, stereotypes, and for the conduct of social science is discussed.

Adult↗

Health effects of housing improvement: systematic review of intervention studies.

OBJECTIVE: To review the evidence on the effects of interventions to improve housing on health. DESIGN: Systematic review of experimental and non-experimental housing intervention studies that measured quantitative health outcomes. DATA SOURCES: Studies dating from 1887, in any language or format, identified from clinical, social science, and grey literature databases, personal collections, expert consultation, and reference lists. MAIN OUTCOME MEASURES: Socioeconomic change and health, illness, and social measures. RESULTS: 18 completed primary intervention studies were identified. 11 studies were prospective, of which six had control groups. Three of the seven retrospective studies used a control group. The interventions included rehousing, refurbishment, and energy efficiency measures. Many studies showed health gains after the intervention, but the small study populations and lack of controlling for confounders limit the generalisability of these findings. CONCLUSIONS: The lack of evidence linking housing and health may be attributable to pragmatic difficulties with housing studies as well as the political climate in the United Kingdom. A holistic approach is needed that recognises the multifactorial and complex nature of poor housing and deprivation. Large scale studies that investigate the wider social context of housing interventions are required.

Case-Control Studies↗

Special report on the political and social contexts of health: Part I. Introduction: objectives and purposes of the study.

This article introduces a series of research projects (carried out by the International Network on Social Inequalities and Health) focused on the impact of politics on policy and the consequences for health and quality of life, an area that has been understudied in the social science literature. The introduction describes the conceptual model that guided the research, centered on the study of how political parties and social agents (such as trade unions) affect social inequalities and mortality indicators through labor market and welfare state policies. The major theme of this research is whether political and social interventions matter in health policy and health outcomes. The introduction also describes the different types of research projects carried out by the International Network at the national levels (among OECD countries) and at the regional and local levels (in the United Kingdom, Italy, Germany, Spain, and Sweden). This Journal issue presents the multinational study and the U.K. case study; the next issue will include the Italian, German, Spanish, and Swedish case studies and the summary and conclusions.

Developed Countries↗

Patients build your practice.

Most health care professionals want a business that is built primarily on their reputation. Even in mature managed care marketplaces, reputation and word of mouth are important components to successful marketing. We all talk, but some people talk and get listened to more than others. The challenge is in knowing who talks and what motivates them to talk about your practice to others. Social science research has uncovered several factors that help you identify the most likely talkers in your practice. While most talkers are socially outgoing, these identifying factors go much deeper than this one element. Specific tactics are illustrated that can be used with these talkers to inspire them to talk more. Low cost, appropriate means of showing appreciation for talkers will inspire even more talk.

Interprofessional Relations↗

Placing the humanities perspective in the health professional curriculum.

Most health professional education consists of three separate stages: a general background that provides a humanities perspective, a core of basic science or theory courses, and lengthy clinical experiences. Challenges to this strict compartmentalization and sequencing have led to limited humanities and social sciences training for health professional students. A constant struggle for time allocation occurs between preclinical and clinical faculty. What place can be found in an already crowded curriculum for a humanities perspective, especially when this perspective has supposedly been addressed at an earlier stage in each student's education? This article proposes that a humanities perspective is one of three distinct themes of a professional's education (along with theory and practice) and also the necessary cultural context out of which the professional judges him- or herself. The importance of the humanities perspective is such that the present sequenced pattern should be reconsidered and more attention given to the integration of the three major educational themes throughout students' training.

Curriculum↗

[Social ecology of the drug problem].

The intrinsic dynamics of addiction problems which--as it can be seen at the current Ecstacy epidemy--are growing, requires a more precise analytical consideration of macro social risk factors. In this case, different action programs of the society and also of the different youth subcultures have to be considered ("maximize": performance, consumption, fun etc.). A conclusive unimodal interpretation of these programs in our pluralistic society hardly helps to understand these phenomena. It is even so, that each of these subprograms represents a multiple risk factor for consumption of stimulants for increasing the performance as tranquilizers can be used to identify leisure time. Also social geographical factors should be considered at such analyses and of course economic aspects are of central interest. The complexity of analytical problems at the social sciences resulted in a reduction of interest during the last years. The boundary between journalistic texts and scientific texts devoted to social analysis of addiction is indistinct. Therefore, it seems to be reasonable, to turn down the level of sociological consideration of the drug problem onto the regional level: City-related rates of prevalence of consumption of illegal drugs are very helpful for understanding social risk factors of drug consumption. A pilot analysis of this issue is presented here.

Cross-Sectional Studies↗

[Psychological theories in the context of an interdisciplinary gerontology (author's transl)].

The integration of the different disciplines of gerontology can be promoted by pointing to the analogies in biological, medical, psychological, and sociological constructs and theories of aging. Max Bürger's construct of "biomorphosis", the functional age approach in physiology, and the principle of homeostasis can contribute to the formulation of hypotheses and theories in the behavioral and social sciences, too. A common frame of reference for this integrated interdisciplinary gerontology is a differential approach which tries to define different patterns of aging, their biological, clinical, social, and psychological conditions, the control and prediction of the aging process within the frame-work of these patterns and the prevention of adverse patterns. An important contribution of behavioral sciences to this differential gerontological is defined by cognitive theories of behavior which point to the decisive role of the perceived (vs. the "objective") situation in selection of responses of the aged.

Aged↗

An interactive and contextual model of community-university collaborations for research and action.

Community-university partnerships for research and action are at the heart of many fields in the social sciences including public health, urban planning, education, and community psychology. These partnerships involve individuals from different backgrounds and disciplines working together to address social issues of importance to the community. This article proposes an interactive and contextual model for developing and sustaining community-university partnerships. The phases in the model include gaining entry into the community, developing and sustaining a mutual collaboration (developing trust and mutual respect, establishing adequate communication, respecting human diversity, establishing a culture of learning, respecting the culture of the setting and the community, and developing an action agenda), and recognizing the benefits and outcomes of partnership work. The model also includes the potential challenges that might threaten the partnership, such as resource inequality and time commitment.

Communication↗

Social capital, disorganized communities, and the third way: understanding the retreat from structural inequalities in epidemiology and public health.

The construct of social capital has recently captured the interest of researchers in social epidemiology and public health. The authors review current hypotheses on the social capital and health link, and examine the empirical evidence and its implications for health policy. The construct of social capital employed in the public health literature lacks depth compared with its uses in social science. It presents itself as an alternative to materialist structural inequalities (class, gender, and race) and invokes a romanticized view of communities without social conflict that favors an idealist psychology over a psychology connected to material resources and social structure. The evidence on social capital as a determinant of better health is scant or ambiguous. Even if confirmed, such hypotheses call for attention to social determinants beyond the proximal realm of individualized sociopsychological infrastructure. Social capital is used in public health as an alternative to both state-centered economic redistribution and party politics, and represents a potential privatization of both economics and politics. Such uses of social capital mirror recent "third way" policies in Germany, the United Kingdom, and United States. If third way policies lose support in Europe, the prominence of social capital there might be short lived. In the United States, where the working class is less likely to influence social policy, interest in social capital could be longer lived or could drift into academic limbo like other psychosocial constructs once heralded as the next big idea.

Community Health Planning↗

Adult-child incest: a review of research and treatment.

Although of long-standing theoretical interest in the social sciences, it is only in recent years that researchers and the helping professions have begun to address the reality of incest as a social problem. This paper reviews the literature which addresses adult-child incest as a form of child abuse. Twenty-six independent empirical studies are examined. Related treatment and theoretical literature is also discussed. The following are highlighted: problems of definition; current reporting statistics; obstacles to reporting; incest as a class phenomenon; characteristics of perpetrators, victims, and the other parent; dynamics and circumstances of the incest family; short- and long-term effects of incest on the victim; treating and preventing incest; and legal requirements regarding incest reporting. Finally, attention is directed to methodological problems--small samples, convenience samples, measurement issues, proper evaluation designs for treatment programs, etc.--which very few of the published studies adequately address. Suggestions are made.

Adaptation, Psychological↗

The biological concept of race and its application to public health and epidemiology.

The category of race is widely used in public health. Although its significance may be clear-cut in some practical situations, an adequate theoretical construct for the concept of race does not exist. Public health appears to lag far behind the other biological sciences in the effort to grapple with the idea of race and its implications for the nature-nurture question. This paper outlines the current anthropological and social perspective on race, and applies this view to problems of disease epidemiology. It is proposed that uncritical use of the traditional biological concept of race has distorted etiological thinking in public health and has proven an obstacle in the development of effective intervention strategies. The pragmatism of medicine and its isolation from social science may account for much of this backwardness.

Cultural Characteristics↗

Hand hygiene: simple and complex.

This review gives an overview of hand hygiene in healthcare and in the community, including some aspects which have attracted little attention, such as hand drying and cultural issues determining hand hygiene behaviour. Hand hygiene is the most effective measure for interrupting the transmission of microorganisms which cause infection both in the community and in the healthcare setting. Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education are inadequate. Hand hygiene must be part of an integrated approach to infection control. Compliance with hand hygiene recommendations is poor worldwide. While the techniques involved in hand hygiene are simple, the complex interdependence of factors which determine hand hygiene behaviour makes the study of hand hygiene complex. It is now recognised that improving compliance with hand hygiene recommendations depends on altering human behaviour. Input from behavioural and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social needs. New strategies to promote hand hygiene worldwide include the formation of public-private partnerships.

Clothing↗

Handwashing: a simple, economical and effective method for preventing nosocomial infections in intensive care units.

As most nosocomial infections are thought to be transmitted by the hands of healthcare workers, handwashing is considered to be the single most important intervention to prevent nosocomial infections. However, studies have shown that handwashing practices are poor, especially among medical personnel. This review gives an overview of handwashing in health care and in the community, including some aspects that have attracted little attention, such as hand drying and cultural issues determining hand hygiene behaviour. Hand hygiene is the most effective measure for interrupting the transmission of micro-organisms which cause infection, both in the community and in the healthcare setting. Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education, are inadequate. Hand hygiene must be part of an integrated approach to infection control. Compliance with hand hygiene recommendations is poor worldwide. While the techniques involved in hand hygiene are simple, the complex interdependence of factors that determine hand hygiene behaviour makes the study of hand hygiene complex. It is now recognized that improving compliance with hand hygiene recommendations depends on altering human behaviour. Input from behavioural and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social needs.

Compliance↗