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PubMed2000

Epilepsy in our world: an ethnographic view.

This paper describes how epilepsy is viewed according to biomedicine and the scientific literature and argues that the subjective experience of people dealing with illness is often overlooked by focusing solely on this approach. A review of the pertinent literature from a social science perspective, mainly anthropology and sociology, illustrates the richness of the lived experience of epilepsy that can be uncovered by using ethnographic and other qualitative methods, including narrative studies, in the interest of informing medical practice and leading to a better understanding and treatment of people with this disorder.

Journal Article↗
PubMed1996

Random Utility Representations of Finite m-ary Relations

Block and Marschak (1960, in Olkin et al. (Eds.), Contributions to probability and statistics (pp. 97-132). Stanford, CA: Stanford Univ. Press) discussed the relationship between a probability distribution over the strict linear rankings on a finite set C and a family of jointly distributed random variables indexed by C. The present paper generalizes the concept of random variable (random utility) representations to m-ary relations. It specifies conditions on a finite family of random variables that are sufficient to construct a probability distribution on a given collection of m-ary relations over the family's index set. Conversely, conditions are presented for a probability distribution on a collection of m-ary relations over a finite set C to induce (on a given sample space) a family of jointly distributed random variables indexed by C. Four random variable representations are discussed as illustrations of the general method. These are a semiorder model of approval voting, a probabilistic model for betweenness in magnitude judgments, a probabilistic model for political ranking data, and a probabilistic concatenation describing certainty equivalents for the joint receipt of gambles. The main theorems are compared to related results of Heyer and Niederee (1989, in E. E. Roskam (Ed.), Mathematical psychology in progress (pp. 99-112). Berlin: Springer-Verlag; 1992, Mathematical Social Sciences, 23, 31-44).

Journal Article↗
PubMed1994

Directions for future research in drug abuse prevention.

This paper describes future directions for research in drug abuse prevention from six perspectives that are relevant to NIH: integrated demand and supply reduction, strategic prevention that addresses whole populations and high risk groups, comprehensive or extended prevention that includes multiple channels and periods for intervention delivery, technology transfer, prevention research methods development, and finally, the overarching perspective of interfacing basic and social science research approaches. Specific research questions are summarized that represent each perspective, with implications for NIH policy.

Drug and Narcotic Control↗
PubMedDate not supplied

Prevention and control research within a changing health care system.

The agenda for behavioral and social science research in cancer prevention and control needs to be assessed and interpreted within the context of a changing health care system. These changes present potential opportunities and barriers to an evolving research agenda. Opportunities include access to defined populations and providers, emphasis on clinical outcomes, and access to clinical and financial data. Barriers include intense competition among providers and an overriding emphasis on cost containment. To meet these challenges, attention needs to be given to developing new partnerships with provider organizations, emphasizing interdisciplinary cooperation and training, and reassessing underlying behavioral assumptions and models.

Cost Control↗
PubMed1982

Models and practice in medicine: menopause as syndrome or life transition?

Biomedical knowledge, like scientific knowledge in general, is a product of a social and culture milieu. Moreover, in the analysis of biomedicine a distinction must be maintained between textual and clinical knowledge. Through examination of medical texts and of social science literature, the susceptibility of menopause to numerous interpretations is demonstrated. The generation of clinical models from current information available to physicians is examined and it is suggested that these can be thought of as folk models. Several current clinical models of menopause are presented and the implications for sociological analysis of the subject discussed.

Adult↗
PubMed1978

A social-psychological perspective on successful community control of high blood pressure: a review.

This review brings together studies dealing with factors that affect participation in screening, referral, and treatment for high blood pressure (HBP). Community-based screening programs are examined first, in order to describe the changing and the current distribution of hypertensives as "unaware," untreated, treated but uncontrolled, and controlled by treatment. Factors influencing this distribution are examined. Next, data on referral, acceptance of treatment, and staying in treatment are discussed, with a special reference to intervention studies. The review then brings in the broader social science literature on the psychosocial dynamics of health-maintaining and risk-reducing behaviors. The article concludes with an interpretive summary and some suggestions for further action.

Attitude to Health↗
PubMed1979

Economic, life, and disorder changes: time-series analyses.

Implicit in recent social science research and political discussions is a model linking the economy to mental disorder through the intervening constructs of life change and trauma. Using time-series analysis of a 16-month survey in Kansas City, Missouri (n = 1,140), economic and noneconomic life events and the Midtown scale were predicted using a variety of economic measures for the standard metropoliton statistical area. Both life event variables and the symptom measure were related positively to unemployment, and absolute economic change measures lagged 1 and 2 months. However, the life event variables were not strongly associated with the Midtown scale. Most striking of the subgroup findings was that, on the Midtown scale, the low-income group was more responsive than the middle-income group to economic fluctuations.

Adolescent↗
PubMed1995

An introduction to nonparametric regression in demographic research.

"My intent in this...paper is to alert demographers to the existence of useful new methods, known collectively as nonparametric (NP) regressions, that have been made possible by reductions in computing costs over the last several decades. NP regressions use brute force computing power to free researchers from the need to make strong a priori assumptions about functional forms, thus allowing greater flexibility and accuracy in modelling relationships than in standard parametric approaches. Increased flexibility and computing power do not eliminate the central role of theory in guiding social science research, but they free empirical analysis from the requirement that relationships between variables must have mathematically convenient shapes....I begin this paper with a discussion of bias-variance tradeoffs in regression models, followed by a discussion of localized regression. Subsequent sections discuss specific NP techniques for bivariate and multivariate regressions, with examples. Throughout this paper I will illustrate with data from 17,851 mothers aged 15-45 who were interviewed in the 1988 U.S. National Maternal and Infant Health Survey." (SUMMARY IN FRE)

Americas↗
PubMed1985

Age-specific mortality and short-term changes in the standard of living: Sweden, 1751-1859.

"The response of mortality to short-term changes in real wages is analyzed here not just in its own right but more particularly as an indicator of long-term shifts in the general standard of living. It is hypothesized that the response would have been stronger the lower the standard of living. The relationship between age-specific mortality levels and real-wage series for Sweden 1751-1860 is analyzed using a distributed-lag model and spectral analysis. The results suggest a real shift in the material standard of living during the period." (summary in FRE)

Demography↗
PubMedDate not supplied

[Naive objectivism in the assessment of behavioral disorders].

Naive objectivism is a widespread attitude in human and social science research, although it disregards important principles of the theory of cognition. In the history of philosophy two naive approaches to the understanding of the world were continually disputed; 1. rationalism which purports unlimited cognitive power of the human mind, 2. a kind of empiricism which denies subjective elements in the process of cognition. Today the overestimation of human understanding is reflected in a dogmatic adherence to specific professional or idealogically biased doctrines and in the dubious ideal of a purely empirical science with its limited applicability to mankind. The exaggerated expectations regarding the inherent lawfulness of the empirical research field is demonstrated by excessive data collection and by the useless attempt to define behavioral disorders as deviation from the statistical norm. However, behavior disorders can only be understood, if the totality of being human is considered. They are to be seen as failing attempts to give and to maintain a meaning to life.

Child Behavior Disorders↗
PubMed1995

Community planning: a national strategy to improve HIV prevention programs.

Beginning in fiscal year (FY) 1994, the Centers for Disease Control and Prevention (CDC), in collaboration with health departments and other human immunodeficiency virus (HIV) prevention partners, set in motion a significant innovation in HIV prevention programs: HIV Prevention Community Planning. This process, implemented by all 65 health departments receiving HIV prevention funds from CDC, requires that the identification and prioritization of HIV prevention needs to be a shared responsibility between the health departments administering the funds and representatives of the affected communities for whom the services are intended. Guidance for this planning process strongly embraces the notion that high priority HIV prevention strategies and interventions must have a sound basis in behavioral and social science and that program planning must begin with an accurate assessment of the epidemiology of the current and projected future HIV epidemic. Rather than mandate a single standardized process for all of the 65 jurisdictions, CDC guidance provides flexibility for each jurisdiction to configure a planning process responsive to its own unique circumstances. However, all planning activities must be guided by 13 essential principles. This article will describe the principles and logistics of HIV Prevention Community Planning, identify the potential program benefits of this new undertaking, and describe implementation challenges.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Funding for medical care research.

Funding for medical care research in the interrelated fields of health services research, clinical decision-making, clinical epidemiology, the medical humanities and social sciences, and medical education has been unstable, and relatively little is available in the form of investigator-initiated grants. Stable funding for these fields is important to society and critical to the healthy development of academic general internal medicine. Strategies to augment funding can include political interventions to increase support for the National Center for Health Services Research and Health Care Technology Assessment and to secure designated funds within the National Institutes of Health. Public funding is also needed for career development awards in these fields. Research support also could be enhanced by establishing a consortium of foundations interested in funding investigator-initiated grants through open competition, by developing a mechanism for reviewing proposals from small foundations, by developing consortia in the private sector to support focused research, and by developing endowments to support research.

Financing, Government↗
PubMed2006

Retinopathy of prematurity screening by non-retinologists.

OBJECTIVE: To detect the screening efficiency of general ophthalmologists (ophthalmic residents) as well as non-ophthalmologists (pediatric residents and nurses posted in neonatal intensive care unit) in screening (ROP) retinopathy of prematurity on the basis of posterior pole vascular changes. METHODS: Prospective consecutive review in a tertiary care hospital setting. Five groups (each comprising of one ophthalmic resident, one pediatric resident and a nurse) examined the posterior pole vessels of 200 eyes of ROP with a direct ophthalmoscope and compared with an ROP specialist using indirect ophthalmoscope. SPSS (Statistical Package for the Social Science), version 10.0 was used for the analysis. RESULTS: Ophthalmic residents findings were: (sensitivity 95.68%, specificity 92.85%, positive predictive value 94.81%, negative predictive value 93.97%; pediatric residents findings were : (sensitivity 92.24%, specificity 88.09%, positive predictive value 91.45%, negative predictive value 89.15%); and nurses, finding were: (sensitivity 88.79%, specificity 85.71%, positive predictive value 89.56%, and negative predictive value 84.70%). The results had no statistically significant difference in diagnostic reliability. Kappa agreement analysis was significant for ophthalmic residents (0.887), pediatric residents (0.805) and nurses (0.744) compared with the ROP specialist. None of the children diagnosed with pre-threshold or threshold ROP was thought to have normal posterior pole vessels by the trainees. CONCLUSIONS: Given adequate training, general ophthalmologists and non-ophthalmologists (pediatricians and nurse practitioners) are independently reliable in detecting posterior pole changes in ROP babies using direct ophthalmoscope and can be provided with a screening protocol.

Female↗