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PubMed1983

A legacy without heirs: Korean indigenous medicine and primary health care.

The ancestral shadow of Korean indigenous medicine is long, alive and kicking. The problem is what role it should have in the future of primary health care. The issue of the integration of past medical systems with the modern ones requires a closer look at theoretical as well as practical issues. In this endeavor, medical social sciences are just beginning to reconstruct models which reflect the real concerns of developing countries. These would challenge the illusion that any medical system is an ahistorical institution with autonomous ideologies or intentions. And while bio-medical interventions have significant effects on health and fertility patterns, the distribution of resources within the society and historical patterns appear to have greater persuasion. The model proposed identifies the indigenous and cosmopolitan medical systems along with the household as the main units of the 'social reproduction' of the society, or, the means by which society is renewed. In the final analysis, integration would mean that a compromised alliance had been created between all institutions involved in social reproduction--including biological reproduction, reproduction of the labour force and society's values and institutions. The key structures are the triangle-indigenous medicine, primary health care and the household. The limitations of their functions are in the modes of production from which they derive their resources, political support and even many of their values.

Community Health Services↗
PubMed2004

Promoting cancer screening: Learning from experience.

This article provides an overview of behavioral and social science cancer screening intervention research and introduces the scope of topics addressed in this supplement to Cancer. The authors identify and address issues to consider before conducting interventions to promote the uptake of screening tests, such as the benefits and harms associated with screening. Trends in the use of cancer screening tests are discussed in the context of their efficacy and adoption over time. Both the development and breadth of social and behavioral intervention research intended to increase the use of effective tests are reviewed as background for the articles that follow. The application of the lessons from this extensive knowledge base not only should accelerate the uptake of the effective cancer screening tests currently available, but also can guide future directions for research.

Breast Neoplasms↗
PubMed2006

Women's access to health care: the legal framework.

The Millennium Development Goals set ambitious targets for women's health, including reductions in maternal and child mortality and combating the spread of HIV/AIDS. The law, which historically has often obstructed women's access to the health care they require, has a dynamic potential to ensure women's access that is being progressively realized. This paper identifies three legal principles that are key to advancing women's reproductive and sexual health. First, law should require that care be evidence-based, reflecting medical and social science rather than, for instance, religious ideology or morality. Second, legal guidance should be clear and transparent, so that service providers and patients know their responsibilities and entitlements without litigation to resolve uncertainties. Third, law should provide applicable measures to ensure fairness in women's access to services, both general services and those only women require. Legal developments are addressed that illustrate how law can advance women's equality, and social justice.

Evidence-Based Medicine↗
PubMed2006

Gender perspective in medicine: a vital part of medical scientific rationality. A useful model for comprehending structures and hierarchies within medical science.

BACKGROUND: During the past few decades, research has reported gender bias in various areas of clinical and academic medicine. To prevent such bias, a gender perspective in medicine has been requested, but difficulties and resistance have been reported from implementation attempts. Our study aimed at analysing this resistance in relation to what is considered good medical research. METHOD: We used a theoretical model, based on scientific competition, to understand the structures of scientific medicine and how they might influence the resistance to a gender perspective in medicine. The model was originally introduced to discuss how pluralism improves rationality in the social sciences. RESULTS: The model provided a way to conceptualise different fields of research in medicine: basic research, applied research, medical philosophy, and 'empowering' research. It clarified how various research approaches within medicine relate to each other, and how they differ and compete. It also indicated why there might be conflicts between them: basic and applied research performed within the biomedical framework have higher status than gender research and other research approaches that are performed within divergent research paradigms. CONCLUSION: This hierarchy within medical research contributes to the resistance to a gender perspective, causing gender bias and making medical scientific rationality suboptimal. We recommend that the theoretical model can be applied in a wider medical context when different and hierarchically arranged research traditions are in conflict. In this way, the model might contribute to shape a medical community where scientific pluralism is acknowledged to enlarge, not to disturb, the scientific rationality of medicine.

Biomedical Research↗
PubMed1995

Miracles take a little longer: project 2000 and the health-promoting nurse.

This paper suggests that the new paradigm for nurse education is being prevented from fulfilling itself because of factors operating within the taught, hidden and wider curriculum. Firstly it is argued that the theoretical components relating to social science, health education/promotion and nursing need to be clearly integrated for nursing students. This integration is demonstrated through the analysis of two nursing models. Secondly it is argued that the taught curriculum needs to be supported by a suitable hidden curriculum both within the educational and clinical setting. Role models which demonstrate integrated theory occurring in practice are a vital component of this. Thirdly it is argued that without the wider social and political context supporting the aims of the 'new' nurse education, meaningful success will be very difficult to achieve.

Curriculum↗
PubMed2004

Situating gender and professional identity in American child study, 1880-1910.

The boundaries of psychological expertise in modern America were often imagined in gendered terms. Studies of child development served as one area where dominant notions of masculinity and femininity collided at a historical moment in which women were increasingly present inthe traditionally male worlds of science and higher education. Attributes that many female authors regarded as necessary qualifications for understanding child development (such as patience, sympathy, and maternal care) were routinely dismissed by male writers as contrary to an authentic scientific disposition. Thus, disputes over the meaning of child development (and the methods of studying it) indicate some of the ways that women's labor was both acknowledged and demoted during the formative years of American social science.

Child↗
PubMed2005

Social context, sexual networks, and racial disparities in rates of sexually transmitted infections.

BACKGROUND: Social context (demographic, socioeconomic, macroeconomic, and sociopolitical features of the environment) influences the epidemiology and consequences of individual behaviors that affect health outcomes. This article examines the role of social context in heterosexual networks that facilitate the spread of human immunodeficiency virus (HIV) infection and other sexually transmitted infections (STIs), particularly in relation to persistent racial disparities in rates of STIs in the United States. METHODS: Review of the medical, public health, and social science literature. RESULTS: Contextual factors, such as poverty, discrimination, epidemiology of illicit drug use in the community, ratio of men to women, incarceration rates, and racial segregation, influence sexual behavior and sexual networks directly and indirectly through a variety of mechanisms. Disparities in these contextual features likely contribute substantially to the persistence of marked racial disparities in rates of STIs. CONCLUSIONS: Given the importance of contextual factors and the sharply contrasting social contexts for blacks and whites, exclusive emphasis on individual risk factors and determinants is unlikely to produce solutions that will significantly decrease HIV rates among blacks. Effective HIV prevention in this population will require multidisciplinary research to address the contextual factors that promote patterns of sexual networks that facilitate transmission of STIs.

Adolescent↗
PubMed2002

Migration and HIV prevention programmes: linking structural factors, culture, and individual behaviour--an Israeli experience.

Migration is one of the structural factors associated with HIV infections, but the dynamic and complex role of migrant situations as determinants of HIV-related vulnerability is still a major issue for social science research. Moreover, interventions to address the specific structural and contextual factors inherent in this association are limited and many do not take into account the cultural components. This paper presents a multi-level framework for analysis of the links between migration and HIV. It includes the association of migration with structural macro factors-lower socio-economic status and limited power in the new society; intermediate structural factors-limited social capital and bi-directional interaction of cultural norms; and individual-level factors-stressors unique to the migration context, depleted psychosocial resources, loss of cultural beliefs and low use of health services. All these factors affect risky sexual behaviour and transmission of HIV. The paper utilises those elements of the framework that are relevant to the specific needs of immigrant populations from the former Soviet Union and from Ethiopia in Israel. We demonstrate their application to integrated, multi-level HIV prevention interventions and propose several special principles for development of migration-related HIV prevention programmes.

Adolescent↗
PubMed2002

Socioeconomic status and child development.

Socioeconomic status (SES) is one of the most widely studied constructs in the social sciences. Several ways of measuring SES have been proposed, but most include some quantification of family income, parental education, and occupational status. Research shows that SES is associated with a wide array of health, cognitive, and socioemotional outcomes in children, with effects beginning prior to birth and continuing into adulthood. A variety of mechanisms linking SES to child well-being have been proposed, with most involving differences in access to material and social resources or reactions to stress-inducing conditions by both the children themselves and their parents. For children, SES impacts well-being at multiple levels, including both family and neighborhood. Its effects are moderated by children's own characteristics, family characteristics, and external support systems.

Achievement↗
PubMedDate not supplied

[The paradigm of historical epistemology: Thomas Kuhn's contribution].

This brief historical analysis of the field of epistemology begins with its initial, speculative phase, moving on to the traditional normative model and continuing through contemporary lines, which are referred to here as 'historical-interpretative'. Common to the latter is harsh criticism of the traditional paradigm, whose shortcomings include not only the limitations of 'logical falsification' and 'empirical verification' but also the prescriptive rigidity of normative meta-science, deemed incompatible with this century's scientific advances. The article analyzes Kuhn's contribution in greater detail, highlighting his original concepts and his redefinitions of earlier concepts and models. To illustrate, some of his categories are used in an analysis of the discovery of the DNA structure. This exploration of the Kuhnian model also makes reference to certain stances taken by normative and post-Kuhnian epistemologists, especially in relation to the social sciences and application of the model to other areas of knowledge.

Historiography↗
PubMed1995

Health, illness, and healing in an uncertain era: challenges from and for medical sociology.

The current situation in health care organizations, among providers and for people, dramatically challenges the "business as usual" roles of medicine, government, insurance companies, the community, and the university. Health care reform marks the first attempt in a century to consider a reconstruction of the social contract between society and medicine. While sociology stands as one of the earliest social sciences to systematically study the health care arena and create a health-focused subfield, there is a perception, not without support, of a desertion of identity from within, an encroachment by other areas from without, and abandonment by the parent discipline. We argue that these situations in medical arenas and in research fields require serious rethinking. The key lies in understanding how these phenomena are related to each other and to larger social forces, and how they offer opportunities, rather than signal limitations, to medical sociologists. We turn to the theoretical tools of sociology to help unravel the complicated challenges that face both policymakers and researchers. After framing these issues in a sociology of knowledge perspective, we use the case of "utilization theory" to illustrate the connections between society and systems of care (as well as studies of them) and to create a future agenda. We end by raising three basic questions: (1) Why is a sociological perspective critical to the understanding of change and reform in health care? (2) Why is medical sociology critical to the survival of the general sociological enterprise? and (3) Why is general sociology critical to the research agenda in medical sociology?

Health Care Reform↗
PubMed2003

Conclusions: from self-knowledge to a science of the self.

Traditional accounts of the self represented in religion, literature, philosophy, and other branches of the humanities, are grounded in the subject's personal introspections. This source of knowledge has had a profound impact on terminology, concepts, and theories of the self. By contrast, the scientific method, which uses observational and experimental data, is aimed at objective analyses. The scientific approach to the self, by its very nature, is distinct from the approach in the humanities, and therefore reveals a different view of the self, and sparks new debate about what the self really is. Moreover, different scientific disciplines, spanning the natural and social sciences, investigate different levels of organization, leading to a multifaceted scientific picture of the self. This conference and volume explored areas where some of the different approaches to the self overlap and will, it is hoped, promote the establishment of a richer, more coherent image of what the self is.

Animals↗
PubMed1995

Cognitive complexity and scanning by Chinese and American students in an American university.

75 Chinese and 75 American students' perceptual styles of cognitive complexity and scanning (focus versus nonfocus) were analyzed. The American students, 22 Chinese women, and 18 Chinese social science and humanities students scored as more complex than the 53 Chinese men and 57 Chinese natural science and engineering students. It was also observed that the Chinese men and American women scored as more focused than the 22 Chinese women and 43 American men.

Adult↗
PubMed1988

Monograph support provided by the National Library of Medicine and its regional medical libraries in the medical behavioral sciences.

The National Library of Medicine's (NLM) monographic resources in the medical behavioral sciences (MBS) were examined to assess NLM's ability to support the needs of researchers writing in this area. A sample of 239 representative monographs derived from citations in MBS-related articles published in 61 journals in 1981 were evaluated. These monographs were limited to works published between 1978 and 1981, inclusive. The subject distribution of the sample included fourteen of the twenty-one main classes in the LC classification, although BF (psychology), H (social sciences), and R (medicine) constituted 80.3% of the sample. The study revealed that NLM held 48.5% of the sample. The holdings of ten research medical libraries, including six of the seven regional medical libraries, were also evaluated in order to gauge NLM's ability to support that element of the medical library network. The holding rates of these libraries ranged widely (9.6% to 36%), although NLM was found to have far more extensive holdings overall, and when assessed against classes BF, H, and R. Overall, NLM could have supplied from 28.8% to 44.5% of the monographs not held by the medical libraries. In only a few cases were the ten medical libraries able to provide access to monographs not held by NLM. The findings of the study indicate that, regardless of NLM's indication of support to the MBS area, the holdings of more general research and academic libraries are essential to support the monograph needs of MBS researchers.

Behavioral Sciences↗
PubMed2005

Considering and enjoying tomorrow: global aging through a human becoming lens.

The aging of the world's population is a global issue of considerable importance to everyone, particularly nursing. Traditional developmental theories and the medical model have either neglected later life or highlighted the losses and deficits associated with advanced age, while more recent research on aging and the human becoming theory has provided a more balanced view. In this column, information from health and social sciences, the human becoming school of thought, and international political debates about aging are interwoven. Some attention is also given to the issues of the retirement and aging of the nurses.

Aged↗
PubMed1996

Epidemiology and health policy--a world of difference? A case-study of a cholera outbreak in Kaputa district, Zambia.

The relationship between epidemiology and health policy is an area of considerable debate. This article demonstrates the use of epidemiological methods to make health policy formulation more 'policy significant' and 'down to earth'. A case-study of a cholera outbreak in Kaputa district, Zambia is used as an illustration. A closer liaison between epidemiology and social sciences is advocated. Epidemiological data should be supplied as feed back to the study population to facilitate community-based action for health.

Cholera↗