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The stratification of social capital and its consequences for self-rated health in Taganrog, Russia.

Russian public health and its social determinants have been the theme of several recent studies. In one of these, Rose [(2000). How much does social capital add to individual health? A survey study of Russians. Social Science & Medicine, 51(9), 1421-1435] puts forward a composite model as a way of getting away from two traditions: one that postulates that social capital influences health independently of human capital attributes (education, social class, income, etc.) and one that postulates that human capital is the main determinant of health, while social capital is more or less irrelevant. In this study, we investigate the composite model, conceptualising social capital as a type of capital, on the basis of Bourdieu. By doing this, not only do the relations between social capital and other types of capital become relevant, but also whether the effect of social capital on health differs depending on the possession of other types of capital. We used the Taganrog survey of 1998 which used structured interviews with the family members of 1,009 households and the response rate was 81%. We found that social capital is stratified by education, and also that its effect on health varies depending on the volume of educational capital possessed. It also seems to be extremely important to specify different types of social capital, in order to get a better overview of possible mechanisms by means of which different types of capital might affect health.

Data Collection↗

Dealing with the aftermath: a qualitative analysis of mental health social workers' reactions after a client suicide.

Social workers provide services to populations with mental health issues, including suicidal ideations and are thus at risk of experiencing a client suicide at some point during their career. Limited research using quantitative methods has explored the effect of client suicide on social workers, but little is known about their reactions from a qualitative standpoint-a method of study that is essential for fully understanding a social science phenomenon. This study addresses the gap in the literature by providing findings from an in-depth qualitative study of 25 mental health social workers who shared their experiences and reactions in the aftermath of a client suicide. Major themes were identified, including both professional and personal reactions of denial, anger, grief, and acceptance. Avoidance and intrusion, as well as additional themes of professional incompetence, responsibility, isolation, and justification were indicated and discussed in the conceptual framework of grief and secondary traumatic stress. The implications for practitioners, administrators, and educators are discussed.

Adult↗

Social environment and health--a social epidemiological frame of reference.

Growing interest in epidemiological studies and prevention has led to increased awareness of the importance of the social environment to health. In this field of research, which might be designated social epidemiology, there is today extensive research into the possible association between different types of social factors and ill-health in the population. This article presents a social epidemiological frame of reference and some social factors of importance when one is studying the relationships between the social environment and health. Important social factors in the model are social stratification, social network, social support and life-style factors. Two other main categories of social factors in the model are circumstances and events related to social stratification or occupation and social network respectively. These may be factors in the external or internal work environment and variables describing the general activity level of the individual or different types of stressful social network-related life events. Other important factors in the model are physiological and clinical factors and three different types of health indicator. In the field of social epidemiological research, there is an increasing need for the development of theoretical models and frameworks as support in the analysis of social factors and health. These could be based on experience and tradition in both epidemiological research and the social sciences.

Epidemiologic Methods↗

From bench to bedside? Biomedical scientists' expectations of stem cell science as a future therapy for diabetes.

The movement of scientific research from the bench to the bedside is becoming an increasingly important aspect of modern 'biomedical societies'. There is, however, currently a dearth of social science research on the interaction between the laboratory and the clinic. The recent upsurge in global funding for stem cell research is largely premised on the promise of translating scientific understanding of stem cells into regenerative medicine. In this paper, we report on the views of biomedical scientists based in the United Kingdom who are involved in human embryonic stem cell research in the field of diabetes. We explore their views on the prospects and problems of translational research in the field of stem cell science. We discuss two main themes: institutional influences on interactions between scientists and clinicians, and stem cell science itself as the major barrier to therapies. We frame our discussion within the emerging literature of the sociology of expectations.

Attitude of Health Personnel↗

Public policy and employment of people with disabilities: exploring new paradigms.

A "sea change" in public attitudes, legislation, and political power at the end of the 20th century in the United States has helped set the stage in the early 21st century for the entry of people with disabilities into the labor force. Major pieces of federal legislation have altered national policy with the intention of maximizing the work force participation of people with disabilities. At the same time, a new theoretical paradigm of disability has emerged, which emphasizes community inclusion, accommodation, and protection of civil rights. This "New Paradigm" of disability can be applied in concert with rigorous behavioral science methodologies to shed light on the outcomes of recent federal policy changes regarding the labor force participation of people with disabilities. In so doing, social science can be used in more meaningful ways to understand both the intended and unintended consequences of federal policy.

Cost-Benefit Analysis↗

Is there social psychiatry beyond psychiatry itself?

The contention of this review is to stress that from its inception psychiatry, as medicine in general, was concerned with social aspects of problems it was called upon primarily to deal with. Social psychiatry can consequently be only a variation of psychiatry in danger of laicization, to the point of becoming a 'false creed' rather than a field of consistent research. The pull, the vague 'social sciences' exert on psychiatry at this instance, could be hazardous.

Community Psychiatry↗

Toward a political-economy of alcoholism: the missing link in the anthropology of drinking.

This paper addresses a shortcoming in the existing anthropological and related social science literature on alcohol use and abuse, namely the general inattention to global political-economic forces that have in the past and continue to reshape social relations and drinking practices cross-culturally. Following a critical review of the dominant approaches adopted in the varying explanations of heavy drinking and alcoholism, several alternative concepts are presented and developed in order to lay the ground for the emergence of a political-economy of alcoholism. The paper urges transcendence of the existing narrow boundaries of inquiry and perspective characteristic of most anthropological study of drinking and drinking problems.

Alcohol Drinking↗

Prioritising family health needs: a time--space analysis of women's health-related behaviours.

Much has been made over the years of the view that health-related geographical research has failed fully to explore the complex and mutually reinforcing impact of social and spatial relations on individual health-related behaviours. At the same time, there is a growing awareness elsewhere in the social sciences and in health services research of the generally inadequate exploration of the role of place particularly at the scale of the local community--in the social construction of health, illness and health care use. This paper aims to contribute to the debate by offering a clear framework within which to analyse the impact of spatially configured social relations at the micro-level. In-depth interview evidence from Liverpool shows that, looking at the problem from the perspective of the opportunity-costs of time-space constraints, is a useful means to understand the distinct ways in which health services are used, when and why, across different social groups and geographical areas. Particular attention is drawn to the different thresholds for decision-making depending upon whose health-related needs are being negotiated within the family. The paper concludes with the latest policy developments in UK primary care which offer professionals the clear opportunity to develop much more sophisticated understandings of what constitutes locally-sensitive health service provision. The argument is that such developments must be based on a firm sense of how individual time-space circumstances interact with conditions in the local area if the best possible use of increasingly scarce and valuable resources is to be achieved--particularly in communities characterised by poverty and social exclusion such as those in Liverpool.

Adult↗

Development of a student nurse practitioner computerized clinical log.

A computerized clinical log was developed and revised over a period of three semesters by the family nurse practitioner students at the University of Texas Health Science Center in San Antonio, Texas. Students entered data on a disk formatted in Microsoft Access, and results were analyzed by the Statistical Packages for the Social Sciences (SPSS). More than 4,000 patient encounters were documented during three semesters. The development and refinement of the computerized log are described. Results are presented and the implications of the database for educational, curricular and employment purposes are discussed.

Adult↗

Use of the equity implementation model to review clinical system implementation efforts: a case report.

This paper presents the equity implementation model (EIM) in the context of a case that describes the implementation of a medical scheduling system. The model is based on equity theory, a well-established theory in the social sciences that has been tested in hundreds of experimental and field studies. The predictions of equity theory have been supported in organizational, societal, family, and other social settings. Thus, the EIM helps provide a theory-based understanding for collecting and reviewing users' reactions to, and acceptance or rejection of, a new technology or system. The case study (implementation of a patient scheduling and appointment setting system in a large health maintenance organization) illustrates how the EIM can be used to examine users' reactions to the implementation of a new system.

Appointments and Schedules↗

Strong Inference: rationale or inspiration?

John Platt's article "Strong Inference" (1964) suggested a general and effective method of scientific investigation. It describes a disciplined strategy of falsification of multiple, clearly formulated hypotheses that is used more regularly in some scientific fields than in others. Platt urged that strong inference be more widely and more systematically applied, particularly in slower-moving fields of science. The article has influenced integrative biological fields since its publication, ranging from ecology to psychology, and has had a substantial following in some of the social sciences. It has also evoked severe criticism for its idealization of certain fields as exemplars and for its imperfections in historiography and philosophy of science. I argue here that the article was more an inspirational tract than the development of a formal scientific methodology. Although both Platt's critics and his adherents appeared to take the article far too seriously, its influence has transcended its limitations.

Biomedical Research↗

Sociologic perspectives on juvenile violence.

In sum, there are four sets of social factors that help us understand why juvenile violence appears when, and where, it does, and why some communities and entire societies are persistently wracked by youth violence whereas others are largely spared its worst expressions. When it comes to the first three factors in particular--deprivation, disorganization, and brutalization--the evidence for these links is as strong as anything in social science, and that evidence is supported by a variety of sources and a variety of methods of investigation. Such investigation includes the knowledge we gain through social intervention. Some of the most effective violence prevention programs are successful precisely because they confront and deflect the social forces that otherwise often lead to violence. Consider, for example, the home-visiting programs that work with poor parents in disorganized communities to lower the risks of child abuse; and some of the more "holistic" or "multisystemic" efforts to work with violent juvenile offenders. The best of these programs work by tackling the problems of social isolation and lack of supports in the community, as well as immediate issues of economic survival for vulnerable families and children. More generally, we know that the availability of steady and rewarding work in the future, of the kind that can reliably sustain a family, is one of the most important factors allowing some youths to "desist" from violence as they mature. These conclusions give us much to be encouraged about, and much to be alarmed about. On the one hand, understanding that youth violence often is rooted in a set of adverse social conditions that are identifiable, and potentially modifiable, is a fundamentally optimistic message. It reminds us that the level of juvenile violence we suffer in America today is neither fated nor inevitable. Other societies that are in many respects much like us suffer far less of it; so could we, and we increasingly understand some of the ways in which we could make that happen. We know that some programs designed to increase opportunities and supports for high-risk youth and families do work, and we know that there are broader social and economic policies--policies that are not abstract visions, but have actually been put into place in societies much like our own--that can significantly diminish the pressures toward violence that are bred by poverty and social insecurity among the young. But knowing what to do is one thing, and actually doing it is another. In this there is much reason for concern. The 7-year economic boom that began in the early 1990s has had salutary effects on youth violence, mainly by providing improved economic opportunities for low-income youth and, accordingly, diminishing the appeal of illegal activities. Despite that extraordinary burst of sustained prosperity, however, too many of America's youth remain impoverished, sometimes desperately so: the boom has had only limited effect on our disturbingly high rates of family poverty, which continue to tower above those of comparable industrial societies. And if the boom should come to an end, and we enter again into a period of rising joblessness for youth and young adults, then much, or all, of the recent gains could be quickly lost. The positive economic trends that have helped take the edge off serious juvenile violence in the past few years, in short, are both partial and fragile. Worse, some of our recent social and economic policies, at both state and federal levels, are working in the opposite direction. Some variants of welfare reform, for example, have tossed many vulnerable families off of public assistance without offering solid economic opportunities in its place. Many more families face this future as federal time limits on public welfare increasingly come into play. Given what we know about the links between deprivation and youth violence, this is not a development we can celebrate. (ABSTRACT TRUNCATED)

Adolescent↗

The growth of meta-analytic literature from 1980 to 1993.

A search of the literature was undertaken to estimate the number of meta-analytic studies that have been published in the social and health sciences to date. Altogether, 1,874 published quantitative reviews were located by the end of 1994: 892 in the health sciences, 982 in the social sciences. Trends from 1980 to 1993 indicate that, while the social sciences embraced the technique earlier, health researchers are now publishing almost twice as many meta-analyses as their social science colleagues.

Data Collection↗